MEDIX, God. 27 Br. 150/151  •  Pregledni članak  •  Hematologija HR ENG

Hemostaza i tromboza u bolesnika s COVID-om 19Hemostasis and thrombosis in patients with COVID-19

Dražen Pulanić

Hemostatički poremećaji i tromboze nastaju u znatnoga broja oboljelih od koronavirusne bolesti 2019. (engl. Coronavirus Disease 2019, COVID-19). Iako je COVID-19 vrlo protrombogena bolest, u nekih bolesnika nastanu i krvareće komplikacije. Postoji više smjernica za tromboprofilaksu u bolesnika s COVID-om 19, od kojih treba istaknuti kliničke smjernice Međunarodnoga udruženja za trombozu i hemostazu (engl. International Society on Thrombosis and Hemostasis, ISTH), 2020 CHEST COVID-19 smjernice, COVID-19 smjernice američkih Nacionalnih instituta za zdravlje (engl. National Institutes of Health, NIH), smjernice Američkoga kardiološkoga društva (engl. American College of Cardiology, ACC) i smjernice Američkoga društva za hematologiju (engl. American Society of Hematology, ASH). Upravo je ASH recentno publicirao nadopunu smjernica o tromboprofilaksi nakon otpusta bolesnika s COVID-om 19, kojima tijekom hospitalizacije nije dokazana tromboza niti postavljena sumnja na trombozu, o čemu postoji najviše kontroverzija i otvorenih pitanja.

Ključne riječi:
COVID-19; hemostaza; koagulacijski poremećaji; trombocitopenija; tromboza

Članak u cijelosti pročitajte u tiskanom izdanju MEDIX, God. 27 Br. 150/151

Hemostatic disorders and thrombosis occur in a significant number of patients with COVID-19 (Coronavirus Disease 2019). Although COVID-19 is a very prothrombogenic disease, some patients develop bleeding complications. There are several guidelines for thromboprophylaxis in patients with COVID 19, among which the clinical guidelines of the International Society for Thrombosis and Hemostasis (ISTH), 2020 CHEST COVID-19 guidelines, the COVID-19 guidelines of the National Institutes of Health (NIH), the American College of Cardiology (ACC) guidelines, and the American Society of Hematology (ASH) guidelines are to be mentioned. It was the ASH that recently published an update to the guidelines on thromboprophylaxis after the discharge of patients with COVID-19 who neither were diagnosed with thrombosis nor was it suspected during hospitalization, about which there are most controversies and open questions.

Key words:
coagulation disorders; COVID-19; hemostasis; thrombocytopenia; thrombosis