Optimization of anticoagulant therapy in elderly patients after viral infection COVID-19

The high incidence of thrombotic complications has led to the widespread use of anticoagulant therapy and prophylaxis in patients with COVID-19 after recovery. One of the most vulnerable groups of the population in relation to COVID-19 are elderly and senile people. The purpose of the study – analysis of literature data on the study of the effectiveness of the use of anticoagulant drags in elderly patients who have had a viral infection COVID-19, with a history burdened by concomitant pathology. The review presents literature data on the effectiveness of the use of anticoagulant therapy in elderly patients after mild or moderate COVID-19 against the background of various somatic diseases. To correct coagulation hemostasis disorders in clinical practice, both time-tested «classic» drags (heparin, warfarin), which require periodic monitoring of the international normalized ratio, and new oral anticoagulants from the group of direct thrombin inhibitors (dabigatran or Pradaxa ® ) and the group of oral inhibitors of activated factor ten (Xa) activity – rivaroxaban (Xarelto ® ), apixaban (Eliquis ® ) and edoxaban (Lixiana ® , Savaysa ® , Roteas ® ) – which have gained wide popularity. The article describes options for anticoagulant and antiplatelet therapy for elderly patients who have had coronaviras infection with various concomitant pathologies (hypertension, coronary heart disease, atherosclerotic cardiosclerosis, thrombosis of cerebral vessels, deep veins of the lower extremities, atrial fibrillation, conditions after stent placement). An analysis of the literature shows that doctors are concerned about the increased risk of thrombotic complications in the new coronaviras infection COVID-19. Early initiation and correct administration of anticoagulant therapy for COVID-19 are an undoubted factor in improving the prognosis in a group of elderly, somatically compromised patients. It has been established that direct oral anticoagulants for the treatment of thrombotic complications after COVID-19 in elderly patients with various comorbidities have a number of advantages over classic drags of this group. They are available, have a convenient method of administration, a regimen for determining and adjusting the dose, and do not require periodic monitoring of the international normalized ratio.