Anticoagulation Prophylaxis in Patients with Coronavirus Infection

INTRODUCTION: Anticoagulation prophylaxis of venous thromboembolism (VTE) is obligatory for hospitalized patients with coronavirus infection, unless contraindicated. Various clinical studies reported a high incidence of thrombotic complications in patients with COVID-19 despite application of anticoagulant therapy (ACT). Therefore, the guidelines from several scientific societies recommend the use of higher doses of anticoagulants for the prevention of VTE in patients with COVID-19 with additional risk factors. Subsequent retrospective studies showed contradictory results in terms of efficiency and safety of prophylactic doses. Currently, there exist prophylactic, intermediate and therapeutic doses of anticoagulant therapy. Of special interest is the choice of an anticoagulant. Today, a clinician may choose from low molecular weight heparin (LMWH), non-fractionated heparin (NFH) and direct oral anticoagulants (DOACs). Even before the coronavirus pandemic it was noted that heparins also have anticoagulant properties, which can favorably affect the outcome of COVID-19. This hypothesis served as the basis for numerous randomized clinical trials to compare various types of ACT and search for effective pharmacological alternatives for VTE prophylaxis in patients with coronavirus infection. CONCLUSION: The article presents a literature review based on the analysis of current Russian and foreign scientific works on investigation of various doses, kinds of anticoagulant prophylaxis of thrombotic complications in patients with coronavirus infection, and their effect on the incidence of venous thrombosis, bleeding and mortality. It also provides data on alternative pharmacological variants for prevention of venous thrombotic complications in patients with coronavirus infection.