id	author	title	date	pages	extension	mime	words	sentences	flesch	summary	cache	txt
cord-351020-wde3ki0k	Allione, Attilio	Switch from oral anticoagulants to parenteral heparin in SARS-CoV-2 hospitalized patients: comment	2020-05-21		.txt	text/plain	672	36	42	Five patients developed pulmonary embolism (PE) during hospitalization, four of them while on prophylactic heparin, and one despite treated with oral anticoagulation with warfarin, since he was carrying a mechanical prosthetic heart valve. In this context, our observation of a case of PE despite anticoagulant therapy with warfarin and INR in therapeutic range could place in favor of a heparin therapy switch also in the category of patients considered to be the greatest thrombotic risk such as mechanical heart valve carriers. We suggest that TEG could guide anticoagulant therapy in critically ill patients with COVID-19 and mechanical heart valves, when coagulation times (i.e., INR and aPTT) may prove unreliable. Viscoelastic testing (thromboelastometry) may have a role in guiding the therapeutic strategy (e.g., switching from VKA to heparin in case of documented hypercoagulability) alongside a close monitoring of fibrinogen, d-dimer, CRP, and LDH, to remain in balance while walking on the tightrope of coagulation. Switch from oral anticoagulants to parenteral heparin in SARS-CoV-2 hospitalized patients	./cache/cord-351020-wde3ki0k.txt	./txt/cord-351020-wde3ki0k.txt