Changing physicians’ attitudes regarding anticoagulant therapy for novel coronavirus infection in 2021

ABSTRACT

Background. Despite a set of anti-epidemic measures, including mass vaccination, the spread of COVID-19-infection in the second half of 2021 continues. This is largely due to the emergence of new, more aggressive strains. One way or another, entry of SARS-CoV-2 virus into human body is still accompanied by development of COVID-19-associated coagulopathy realized in various thrombotic complications. Current clinical guidelines, already the 12th revision, describe the main approaches to treatment and prevention of venous thromboembolic complications, but their implementation is not always possible. Despite the increasing awareness of clinicians concerning pathogenetic aspects of infectious process development, a significant number of deviations and disorders, including those of systemic nature, still occur in real practice largely due to excessive desire to prevent some of them. Objectives: to study real clinical practice changes in treatment and prevention of thrombotic complications in patients with new COVID-19-infection. Materials/Methods. The work was based on two anonymous surveys conducted in February and August 2021 with the participation of 223 and 131 physicians treating patients with chronic and acute vascular diseases, respectively. The questionnaires included 17 questions describing physicians’ attitudes regarding treatment choices, use of pharmaceuticals, and methods of hemostasis monitoring. Results. The results of the questionnaires revealed a continuing high degree of awareness among the medical community about the increased risk of thrombotic complications in COVID-19 and the need to correct coagulopathy by prescribing adequate anticoagulant therapy (ACT). Low molecular weight heparins (LMWHs) retain the highest degree of confidence among respondents in inpatient ACT, although the number of physicians recommending new oral anticoagulants (NOACs) is increasing, despite the lack of high-quality randomized trials confirming their effectiveness. There has been an increase in respondents’ awareness of issues related to hemostasis laboratory control. Conclusions. The results obtained indicate the need to continue the information campaign regarding the prevention of COVID-19-coagulopathy among healthcare workers. © 2021, Hemostasis and Rheology LLC. All rights reserved.