Impact of proactive low-molecular weight heparin therapy on outcomes in COVID-1

Bratislava Medical Journal

article

S. Gormez¹  H. K. Gumusel²  E. Ekicibasi³  A. Degirmencioglu⁴  A. Paudel⁵  G. Akan⁶  F. Atalar⁷  R. Erdim⁸  E. Eroglu⁹  S. Dagdelen⁹  N. Sariguzel^1,10  C. E. Kirisoglu^1,11  B. Pamukcu^1,12 

[1] Health Sciences University Faculty of Medicine Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Interventional Pulmonology Department;Acibadem, Kadikoy Hospital, Department of Cardiology;Acibadem Mehmet Ali Aydinlar University, Vocational School of Health Services, Acibadem Altunizade Hospital, Department of Cardiology;Acibadem Mehmet Ali Aydinlar University, Faculty of Medicine, Department of Cardiology, Acibadem Maslak Hospital;Acibadem Altunizade Hospital, Department of Cardiology;Muhimbili University of Health and Allied Sciences, Department of Biochemistry, MUHAS Genetics Laboratory;Istanbul University, Child Health Institute, Department of Family Health;Acibadem Mehmet Ali Aydinlar University, Vocational School of Health Services, Acibadem Kadikoy Hospital, Department of Cardiology;Acibadem Mehmet Ali Aydinlar University, Faculty of Medicine, Department of Cardiology, Acibadem Altunizade Hospital;Acibadem Kadikoy & Kozyatagi Hospitals, Department of Infection Diseases Istanbul;Acibadem Mehmet Ali Aydinlar University, Faculty of Medicine, Department of Chest Diseases and Tuberculosis, Acibadem Kozyatagi Hospital;Acibadem Mehmet Ali Aydinlar University, Vocational School of Health Services, Department of First and Emergency Aid, Acibadem Kozyatagi Hospital, Department of Cardiology

关键词: COVID-19;    SARS-CoV-2;    thrombosis;    antithrombotic therapy;    low-molecular-weight heparin;    D-dimer;    enoxaparin;   

DOI  :  10.4149/BLL_2021_093

学科分类：医学（综合）

来源: AEPress, s.r.o.

【 摘 要 】

OBJECTIVES: Low molecular weight heparin (LMWH) may provide beneficial effects on outcomes of COVID-19. We aimed to examine the impact of LMWH treatment on clinical outcomes (duration of hospitalization, admission to intensive care unit, the requirement for mechanical ventilation, and death) of COVID-19 patients with normal D-dimer levels at admission. BACKGROUND: Coronavirus disease-2019 (COVID-19) predisposes patients to arterial and venous thrombosis. METHODS: In this retrospective, multicentre and observational study we analysed the data of 308 confirmed COVID-19 patients with normal D-dimer levels at initial admission. After propensity score matching (PSM) patients were grouped; Group 1; patients who received LMWH with D-dimer ≤0.5 mg/L, Group 2; patients who received LMWH after D-dimer levels exceeded 0.5 mg/L, and Group 3; patients who did not receive LMWH. RESULTS: After PSM, each group comprised 40 patients. The patients in Group1 had the best clinical outcomes compared to the other groups. Group 3 had the worst clinical outcomes (p<0.005). The benefit of LMWH increased with early prophylactic therapy especially when started while the D-dimer levels were ≤0.5 mg/L. CONCLUSION: Our results strongly suggest that proactive LMWH therapy improves clinical outcomes in hospitalized COVID-19 patients even with normal D-dimer levels (≤ 0.5 mg/L) (Tab. 3, Fig. 2, Ref. 34).

【 授权许可】

CC BY