Table 2.

Indications for patients receiving chronic antithrombotic treatments admitted for COVID-19

Patients on chronic antiplatelet therapy

Aspirin therapy for primary cardiovascular prevention should be continued, unless contraindications have arisen or there is need for venous thromboprophylaxis

Antiplatelet therapy for secondary cardiovascular prevention must be continued, considering possible drug interactions

Dual antiplatelet therapy in patients who have undergone PCI within ≤ 3 months must be continued unless hemorrhagic events are reported

In patients on aspirin plus clopidogrel/ticagrelor who have undergone a recent PCI (≤ 3 months) for ACS requiring treatment with lopinavir/ritonavir or atazanavir, switching from clopidogrel/ticagrelor to prasugrel is indicated. If prasugrel is contraindicated, therapy with clopidogrel/ticagrelor is continued, monitoring blood cell count and ischemic/bleeding events

In patients on aspirin plus clopidogrel who have undergone a recent PCI (≤ 3 months) for stable coronary syndrome requiring treatment with lopinavir/ritonavir or atazanavir, clopidogrel is continued, monitoring blood cell count and ischemic events

No significant interaction between clopidogrel/prasugrel/ticagrelor and the other agents used for COVID-19 are present

Patients on chronic OAC

If indication for OAC is adequate and no contraindication exists, short-term switching from OAC to LMWH is reasonable

ACS acute coronary syndrome, COVID-19 coronavirus disease 2019, LMWH low-molecular weight heparin, OAC oral anticoagulant therapy, PCI percutaneous coronary intervention