of healthcare workers in order to monitor blood levels. Consequently, LMWH is preferred.
American College of Obstetricians and Gynecologists and Maternal Fetal Medicine recommends prophylactic dose anticoagulation unless contraindicated 57,58 . CONCLUSION In patients with COVID-19, cardiovascular complications are not uncommon and portend a worse prognosis, especially in patients with preexisting cardiovascular disease. Cardiovascular treatment strategies in COVID-19 patients continue to evolve. Considerations for the preventive and therapeutic use of antithrombotic agents to mitigate the thrombotic and hemorrhagic events in these high-risk patients should always be the priority. There should be a focus on prevention, acute management, and long-term outcomes of coronavirus disease–related cardiometabolic syndrome. Healthcare workers must educate patients especially those with cardiovascular diseases to seek prompt medical care if they become ill.
The guideline panels of American Society of Hematology, American College of Chest Physicians and World Health Organization recommend treating all hospitalized and critically ill patients with COVID-19 with prophylactic dose anticoagulation 52,53,54 . A meta-analysis which compared thrombotic and bleeding outcomes in patients with COVID-19 treated with prophylactic dose anticoagulation versus intermediate or therapeutic doses concluded that the odds of VTE and mortality were not different between thesegroups 55 . As per the recent National Institutes of Health (NIH) COVID-19 treatment guidelines, VTE prophylaxis is not recommended for patients with COVID-19 who are discharged from hospital 56 . Non-hospitalized patients with COVID-19 should not be initiated on anticoagulants and antiplatelet therapy for the prevention of VTE or arterial thrombosis unless they have other indications for the therapy 56 . For pregnant patients hospitalizedwith COVID-19,
Figure: Expression of ACE2 in various tissues. The disease manifestations of COVID-19 in lungs, heart and vasculature is shown on the right. (Created with BioRender.com)
infected with 2019 novel coronavirus in Wuhan, China [published correction appears in Lancet. 2020 Jan 30;:]. Lancet. 2020;395(10223):497-506. doi:10.1016/S0140- 6736(20)30183-5 3. Hamming I, Timens W, Bulthuis ML, Lely AT, Navis G, van Goor H. Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding
REFERENCES 1. “Louisiana Coronavirus COVID-19: Department of Health: State of Louisiana.” Louisiana Coronavirus COVID-19 | Department of Health | State of Louisiana, ldh.la.gov/ Coronavirus/. (Accessed on January 21 st , 2021). 2. Huang C, Wang Y, Li X, et al. Clinical features of patients
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