Fondaparinux Use in Patients With COVID-19: A Preliminary Multicenter Real-World Experience.
Aged
Anticoagulants
/ adverse effects
Antithrombins
/ adverse effects
COVID-19
Coronavirus Infections
/ complications
Enoxaparin
/ adverse effects
Factor Xa Inhibitors
/ adverse effects
Female
Fondaparinux
/ adverse effects
Hemorrhage
/ chemically induced
Hospital Mortality
Humans
Incidence
Male
Middle Aged
Pandemics
Pneumonia, Viral
/ complications
Pulmonary Embolism
/ complications
Retrospective Studies
Venous Thromboembolism
/ epidemiology
Venous Thrombosis
/ epidemiology
Journal
Journal of cardiovascular pharmacology
ISSN: 1533-4023
Titre abrégé: J Cardiovasc Pharmacol
Pays: United States
ID NLM: 7902492
Informations de publication
Date de publication:
10 2020
10 2020
Historique:
entrez:
7
10
2020
pubmed:
8
10
2020
medline:
21
10
2020
Statut:
ppublish
Résumé
The use of heparin has been shown to decrease the mortality in hospitalized patients with severe COVID-19. The aim of our study was to evaluate the clinical impact of venous thromboembolism prophylaxis with fondaparinux versus enoxaparin among 100 hospitalized COVID-19 patients. The incidence of pulmonary embolism, deep venous thrombosis, major bleeding (MB), clinically relevant non-MB, acute respiratory distress syndrome, and in-hospital mortality was compared between patients on fondaparinux versus enoxaparin therapy. The 2 groups were homogeneous for demographic, laboratory, and clinical characteristics. In a median follow-up of 28 (IQR: 12-45) days, no statistically significant difference in venous thromboembolism (14.5% vs. 5.3%; P = 0.20), MB and clinically relevant non-MB (3.2% vs. 5.3%, P = 0.76), ARDS (17.7% vs. 15.8%; P = 0.83), and in-hospital mortality (9.7% vs. 10.5%; P = 0.97) has been shown between the enoxaparin group versus the fondaparinux group. Our preliminary results support the hypothesis of a safe and effective use of fondaparinux among patients with COVID-19 hospitalized in internal medicine units.
Identifiants
pubmed: 33027192
doi: 10.1097/FJC.0000000000000893
pii: 00005344-202010000-00001
doi:
Substances chimiques
Anticoagulants
0
Antithrombins
0
Enoxaparin
0
Factor Xa Inhibitors
0
Fondaparinux
J177FOW5JL
Types de publication
Comparative Study
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
369-371Références
Russo V, Rago A, Carbone A, et al. Atrial fibrillation in COVID-19: from epidemiological association to pharmacological implications [published online ahead of print, 2020 May 18]. J Cardiovasc Pharmacol. 2020;76:138–145.
Di Micco P, Russo V, Carannante N, et al. Clotting factors in COVID-19: epidemiological association and prognostic values in different clinical presentations in an Italian cohort. J Clin Med. 2020;9:1371.
Tang N, Bai H, Chen X, et al. Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy. J Thromb Haemost. 2020;18:1094–1099.
Middeldorp S, Coppens M, van Haaps TF, et al. Incidence of venous thromboembolism in hospitalized patients with COVID-19. J Thromb Haemost. 2020;18:1995–2002.
Kumar A, Talwar A, Farley JF, et al. Fondaparinux sodium compared with low molecular-weight heparins for Perioperative surgical thromboprophylaxis: a systematic review and meta-analysis. J Am Heart Assoc. 2019;8:e012184.
Available at: https://www.who.int/publications-detail/clinical-management-of-severe-acute-respiratory-infection-when-novel-coronavirus-(ncov)-infection-is-suspected. Accessed August 25, 2020.
Barbar S, Noventa F, Rossetto V, et al. A risk assessment model for the identification of hospitalized medical patients at risk for venous thromboembolism: the Padua Prediction Score. J Thromb Haemost. 2010;8:2450–2457.
Kaatz S, Ahmad D, Spyropoulos AC, et al. Definition of clinically relevant non-major bleeding in studies of anticoagulants in atrial fibrillation and venous thromboembolic disease in non-surgical patients: communication from the SSC of the ISTH. J Thromb Haemost. 2015;13:2119–2126.
ARDS Definition Task Force, Ranieri VM, Rubenfeld GD, Thompson BT, et al. Acute respiratory distress syndrome: the Berlin Definition. JAMA. 2012;307:2526–2533.
Russo V, Bottino R, Carbone A, et al. COVID-19 and heart: from clinical features to pharmacological implications. J Clin Med. 2020;9:1944.
Russo V, Di Maio M, Attena E, et al. Clinical impact of pre-admission antithrombotic therapy in hospitalized patients with COVID-19: a multicenter observational study [published online ahead of print, 2020 May 29]. Pharmacol Res. 2020;159:104965.
Kahn SR, Lim W, Dunn AS, et al. Prevention of VTE in nonsurgical patients: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of chest Physicians Evidence-Based clinical practice Guidelines. Chest. 2012;141(2 suppl):e195S–e226S.
Klok FA. Confirmation of the high cumulative incidence of thrombotic complications in critically ill ICU patients with COVID-19: an updated analysis. Thromb Res. 2020;191:148–150.
Cui S, Chen S, Li X, et al. Prevalence of venous thromboembolism in patients with severe novel coronavirus pneumonia. J Thromb Haemost. 2020;18:1421–1424.
Zhang Z, Zhai Z, Yang Y, et al. Diabetes mellitus is associated with increased bleeding in pulmonary embolism receiving conventional anticoagulant therapy: findings from a “real-world” study. J Thromb Thrombolysis. 2017;43:540–549.