russjcardiolРоссийский кардиологический журналRussian Journal of Cardiology1560-40712618-7620«SILICEA-POLIGRAF» LLC10.15829/1560-4071-2021-4652russjcardiol-4652Research ArticleОБЗОРЫ ЛИТЕРАТУРЫREVIEWНеобходима ли антикоагулянтная терапия после выписки из стационара с COVID-19-ассоциированной пневмонией?Is anticoagulant therapy necessary after hospitalization with COVID-19 pneumonia?https://orcid.org/0000-0002-5972-6418ДавтянП. А.DavtyanP. A.

Ординатор, кафедра пропедевтики внутренних болезней.

Уфа.

Ufa.

davtyanapruir@gmail.comhttps://orcid.org/0000-0002-6110-0377ГумеровР. М.GumerovR. M.

Ассистент, кафедра пропедевтики внутренних болезней.

Уфа.

Ufa.

rmgumerov@gmail.comhttps://orcid.org/0000-0002-7249-3364ЗагидуллинШ. З.ZagidullinSh. Z.

Профессор, доктор медицинских наук, кафедра пропедевтики внутренних болезней.

Уфа.

Ufa.

zshamil@inbox.ruhttps://orcid.org/0000-0001-9302-499XСамородовА. В.SamorodovA. V.

И.о. заведующего кафедрой фармакологии с курсом клинической фармакологии.

Уфа.

Ufa.

AVSamorodov@gmail.comhttps://orcid.org/0000-0002-6342-4930ЦайБ.CaiB.

Профессор кафедры фармации второй аффилиатной больницы и кафедры фармакологии фармацевтического колледжа, профессор.

Харбин.

Harbin.

caibz@ems.hrbmu.edu.cnhttps://orcid.org/0000-0003-2386-6707ЗагидуллинН. Ш.ZagidullinN. Sh.

Профессор, доктор медицинских наук, заведующий кафедрой пропедевтики внутренних болезней.

Уфа.

Ufa.

znaufal@mail.ruБашкирский государственный медицинский университет Минздрава РоссииРоссияBashkir State Medical UniversityRussian FederationХарбинский медицинский университетКитайHarbin Medical UniversityChina202126122021264SОбразование46524652Copyright © Давтян П.А., Гумеров Р.М., Загидуллин Ш.З., Самородов А.В., Цай Б., Загидуллин Н.Ш., 20222022Давтян П.А., Гумеров Р.М., Загидуллин Ш.З., Самородов А.В., Цай Б., Загидуллин Н.Ш.Davtyan P.A., Gumerov R.M., Zagidullin S.Z., Samorodov A.V., Cai B., Zagidullin N.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://russjcardiol.elpub.ru/jour/article/view/4652

Пандемия новой коронавирусной инфекции (COVID-19) связана с высокой вирулентностью, смертностью и нагрузкой на систему здравоохранения во всём мире. Одной из её особенностей является прокоагулянтная активность, которая приводит к высокой частоте тромбоэмболических осложнений в сосудах лёгких и других органов. Поэтому с самого начала заболевания при среднетяжёлом течении в качества антикоагулянтов стали использоваться низкомолекулярные гепарины, которые доказали своё благоприятное влияние на смертность и течение болезни и вошли во все рекомендации. Однако противоречивым является вопрос о необходимости антикоагулянтной терапии после выписки из стационара. Мнения различных медицинских профессиональных сообществ по данному вопросу разделились. В частности, некоторые из них, в т.ч. рекомендации Минздрава России, рекомендуют терапевтическую антикоагуляцию с помощью новых оральных антикоагулянтов (дабигатран, ривароксабан, апиксабан) на период 30-45 дней, однако в других источниках подобные рекомендации отсутствуют. В данном обзоре обсуждаются вопросы эффективности антикоагулянтной терапии после COVID-19, а также необходимости использования стратификационных шкал для оценки данной терапии.

The coronavirus disease 2019 (COVID-19) pandemic is associated with high virulence, mortality and healthcare burden around the world. One of its features is procoagulant activity, which leads to a high incidence of thromboembolic events in the lungs and other organs. Therefore, from the very onset of the moderate COVID-19, low molecular weight heparins began to be used as anticoagulants, which proved to have a beneficial effect on mortality and the disease course and were included in all guidelines. However, the question on anticoagulant therapy need after discharge from the hospital is controversial. The opinions of various medical professional communities on this issue are divided. In particular, some of them, including the Russian Ministry of Health guidelines recommend 30-45day anticoagulation using novel oral anticoagulants (dabigatran, rivaroxaban, apixaban), but other sources do not provide such recommendations. This review discusses the effectiveness of anticoagulant therapy after COVID-19, as well as the need to use stratification scales to assess this therapy.

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The authors declare that there are no conflicts of interest present.