Problems of VirologyProblems of Virology0507-40882411-2097Central Research Institute for Epidemiology47510.36233/0507-4088-14Effect of anticoagulant therapy on the course of COVID-19 in comorbid patientsRuzhentsovaT. A.<p class="MsoNormal"><span lang="EN-US">Tatiana A. Ruzhentsova - Ph.D., D.Sci. (Med.), Head of Clinical Research Department, Professor of the Educational Center.</span></p><p class="MsoNormal"><span lang="EN-US">Moscow, 125212</span></p>ruzhencova@gmail.comhttps://orcid.org/0000-0002-6945-2019KhavkinaD. A.<p>Darya A. Khavkina - Statistician of the Clinical Research Department</p><p>Moscow, 111123</p>havkina@gmail.comhttps://orcid.org/0000-0001-5919-9841ChukhliaevP. V.<p>Pavel V. Chukhliaev - Methodologist of the Clinical Research Department.</p><p class="MsoNormal">Moscow, 111123</p>pafachka@gmail.comhttps://orcid.org/0000-0003-1210-1215GarbuzovA. A.<p>Alexander A. Garbuzov - Methodologist of the Clinical Research Department.</p><p class="MsoNormal">Moscow, 111123</p>os.vertebra@mail.ruhttps://orcid.org/0000-0002-3378-8418PloskirevaA. A.<p>Antonina A. Ploskireva - Ph.D., D.Sci. (Med.), Assistant Professor, Associate Director for Clinical Affairs.</p><p class="MsoNormal">Moscow, 111123</p>antonina@ploskireva.comhttps://orcid.org/0000-0002-3612-1889FSBI Gabrichevsky research institute for epidemiology and microbiology of the Surveillance of Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor)FSBI Central Research Institute for Epidemiology of the Surveillance of Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor)0703202166140460703202107032021Copyright © 2021, Ruzhentsova T.A., Khavkina D.A., Chukhliaev P.V., Garbuzov A.A., Ploskireva A.A.2021<p class="MsoNormal"><strong><span lang="EN-US">Introduction. </span></strong><span lang="EN-US">Analysis of the pathogenesis of coronavirus infection caused SARS-CoV-2 indicates a significant impact of hemorheological disorders on its course and outcomes. It is known that chronic cardiovascular diseases are associated with the risk of severe course and lethal outcomes both in COVID-19 and other infectious diseases. Therefore, in each case it is necessary to study the interaction and mutual influence of different components of the treatment program prescribed to such patients.</span></p><p class="MsoNormal"><strong><span lang="EN-US">The purpose</span></strong><span lang="EN-US"> of this work was to evaluate the effect of coagulation activity on the course of a novel coronavirus infection (COVID-19) and to justify the management of comorbid patients having been received novel oral anticoagulants (NOACs) in previously selected doses according to indications in concomitant somatic diseases.</span></p><p class="MsoNormal"><strong><span lang="EN-US">Material and methods</span></strong><span lang="EN-US">. Total 76 cases of confirmed coronavirus infection in patients who had been received initial therapy on an outpatient basis were analyzed. 26 patients who received NOACs (rivaroxaban, apixaban, dabigatran) made up the main group and 50 - the comparison (control) group in which patients had not been administered any drugs that affect blood clotting until the episode of COVID-19. All patients have been prescribed therapy following the Provisional guidelines «Prevention, diagnosis and treatment of coronavirus infection (COVID-19)» (https://static-0.minzdrav.gov.ru/system/attachments/attaches/).</span></p><p class="MsoNormal"><strong><span lang="EN-US">Results and discussion</span></strong><span lang="EN-US">. The number of hospitalizations was significantly fewer in the group of patients who had been received NOACs (19 vs. 66% in the control group). No deaths or cases of severe respiratory and/or renal failure were observed in the main group, while adverse outcomes were noted in 14% of patients who had not been administered these drugs.</span></p><p class="MsoNormal"><strong><span lang="EN-US">Conclusion.</span></strong><span lang="EN-US"> Taking NOACs reduces the probability of severe course and adverse outcomes in the development of coronavirus infection caused by SARS-CoV-2, which indicates a significant contribution of coagulation mechanisms to the pathogenesis in COVID-19. There were no indications for drug replacement and correction of anticoagulant therapy regimens in patients who received adequate therapy with oral anticoagulants for treating a non-severe form of coronavirus infection in ambulatory patient settings.</span></p>novel oral anticoagulantsanticoagulant therapySARS-CoV-2coronavirus infectionCOVID-19atrial fibrillationпероральные антикоагулянтыантикоагулянтная терапияSARS-CoV-2коронавирусная инфекцияCOVID-19фибрилляция предсердий[1. Paranjpe I., Fuster V, LalaA., RussakA.J., Glicksberg B.S., Levin M.A., et al. Association of treatment dose anticoagulation with in-hospital survival among hospitalized patients with COVID-19. J. Am. Coll. Cardiol. 2020; 76(1): 122-9. https://doi.org/10.1016/).jacc.2020.05.001.][2. Lillicrap D. Disseminated intravascular coagulation in patients with 2019-nCoV pneumonia. J. Thromb. Haemost. 2020; 18(4): 786-7. https://doi.org/10.1111/jth.14781.][3. Tang N., Bai H., Chen X., Gong J., Li D., Sun Z. Anticoagulant treatment is associated with decreased mortality in severe coronavi-rus disease 2019 patients with coagulopathy. J. Thromb. Haemost. 2020; 18(5): 1094-9. https://doi.org/10.1111/jth.14817.][4. Wu J., Liu J., Zhao X., Liu C., Wang W., Wang D., et al. Clinical characteristics of imported cases of COVID-19 in Jiangsu Province: A multicenter descriptive study. Clin. Infect. Dis. 2020; 71(15): 706-12. https://doi.org/10.1093/cid/ciaa199.][5. Steffel J., Verhamme P., Potpara T.S., Albaladejo P., Antz M., Desteghe L., et al. The 2018 European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation. Eur. Heart J. 2018; 39(16): 1330-93. https://doi.org/10.1093/eurheartj/ehy136.]