Thread by @TH_Journal

📌Impact of #Covid_19😷outbreaks on #anticoagulation use 💉💊

Read our #interview with the author Ippazio Cosimo Antonazzo @unimib in our thread 🧵 below ⬇️

Accepted manuscript 🆓access
thieme-connect.com/products/ejour… @ThiemeNY @ThiemeGruppe

Why did you (and your colleagues) write this paper? What was its main purpose?

Ippazio Cosimo Antonazzo: "In the last months, the body of literature on COVID-19 pandemic impact on healthcare facilities access has increased."
1/12

"However, few studies focused on potential impact of outbreak on drug utilization in the general population, particularly for those medications requiring intense monitoring and/or constant access to healthcare facilities."
2/12

"This is why we decided to focus on anticoagulants, also considering the extensive use in the population."
3/12

What are the main conclusions?

"Our findings suggest a decreased incidence of anticoagulants use during the lockdown period compared with the pre-and post-lockdown phases for both DOACs and VKAs. Several factors might have influenced the observed decrease."
4/12

"The main hypothesis is that the drop in hospital access due to cardiovascular diseases as well as the drop/postponement of elective surgery services might have resulted in an abrupt drop of anticoagulants use in the general population. "
5/12

What are the paper’s implications?- to the public?-to medical professionals?

"The reduction in the incidence of anticoagulants use can be considered as an indirect estimation of the under-diagnosis of cardiovascular diseases."
6/12

"This was potentially associated with the healthcare facilities reorganization that occurred during the lockdown period."
7/12

"This suggests that outpatient management should be improved by adopting ad hoc diagnostic and therapeutic assistance paths, which allow diagnosis of cardiovascular diseases, during future COVID-19 waves or new emergency situations."
8/12

Are the findings clinically significant? Should the findings change practice?

"This is an observational study that aimed at describing a specific phenomenon (anticoagulants use) in a specific time point (COVID-19 outbreak)."
9/12

"Although these results are unlikely to change clinical practice, they suggest that lockdown enhanced the reduction of VKAs use that was already underway."
10/12

"As reported in the paper, the incidence of VKAs significantly decreased during the lockdown without returning to the pre-lockdown status, whereas in the case of DOACs we have observed a significant increase in the post-lockdown."
11/12

"Therefore, we may suppose that the clinical practice in the anticoagulants use was already changing prior the COVID-19 outbreak, and the lockdown has only accelerated this process of shift from VKAs to DOACs.
"
12/12

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