Antithrombotic and Anti-Inflammatory Effects of Fondaparinux and Enoxaparin in Hospitalized COVID-19 Patients: The FONDENOXAVID Study.
COVID-19
D-dimer
SARS-CoV2
enoxaparin
fibrinogen
fondaparinux
venous thromboembolism
Journal
Journal of blood medicine
ISSN: 1179-2736
Titre abrégé: J Blood Med
Pays: New Zealand
ID NLM: 101550884
Informations de publication
Date de publication:
2021
2021
Historique:
received:
04
10
2020
accepted:
26
01
2021
entrez:
19
2
2021
pubmed:
20
2
2021
medline:
20
2
2021
Statut:
epublish
Résumé
Since the outbreak of novel coronavirus SARS-CoV2 around the world, great attention has been paid to the effects of such antithrombotic drugs as heparinoids, because they have antiviral action in vitro and antithrombotic actions in vivo. We conducted a retrospective analysis in inpatients with confirmed COVID-19 on the anti-inflammatory and antithrombotic effects of enoxaparin and fondaparinux at prophylactic doses. This retrospective cohort study used patients with confirmed COVID-19 during the first months of the Italian outbreak from February 18 to April 30, 2020. Our aim was to compare clinical characteristics, prophylactic treatment, markers of inflammation, and thrombotic outcomes in inpatients positive for SARS-CoV2 during hospitalization associated with thromboprophylaxis with enoxaparin (40 mg or 60 mg once daily) or fondaparinux (2.5 mg once daily). Statistical analysis was conducted with using MatLab R2016B and ad hoc functions. There were no significatant differences in clinical characteristics between patients that used enoxaparin or fondaparinux as thromboprophylaxis for SARS-CoV2. No differences were found in D-dimer and fibrinogen levels either, which were used as markers of inflammation during the infection at testing on admission and after 3 weeks.Significant differences in CRP, IL6, and LDH were found in patients after 21 days' treatment. Increased levels of fibrinogen and D-dimer in patients with confirmed COVID-19 have been reported in several studies. Our results showed that anti-inflammatory effects of fondaparinux and enoxaparin after 3 weeks of prophylactic treatment were similar when levels of fibrinogen and D-dimer were considered. Furthermore, levels of CRP showed a decrease in patients treated with enoxaparin and fondaparinux, although the decrease in the fondaparinux group seems to be more relevant.
Sections du résumé
BACKGROUND
BACKGROUND
Since the outbreak of novel coronavirus SARS-CoV2 around the world, great attention has been paid to the effects of such antithrombotic drugs as heparinoids, because they have antiviral action in vitro and antithrombotic actions in vivo. We conducted a retrospective analysis in inpatients with confirmed COVID-19 on the anti-inflammatory and antithrombotic effects of enoxaparin and fondaparinux at prophylactic doses.
METHODS
METHODS
This retrospective cohort study used patients with confirmed COVID-19 during the first months of the Italian outbreak from February 18 to April 30, 2020. Our aim was to compare clinical characteristics, prophylactic treatment, markers of inflammation, and thrombotic outcomes in inpatients positive for SARS-CoV2 during hospitalization associated with thromboprophylaxis with enoxaparin (40 mg or 60 mg once daily) or fondaparinux (2.5 mg once daily). Statistical analysis was conducted with using MatLab R2016B and ad hoc functions.
RESULTS
RESULTS
There were no significatant differences in clinical characteristics between patients that used enoxaparin or fondaparinux as thromboprophylaxis for SARS-CoV2. No differences were found in D-dimer and fibrinogen levels either, which were used as markers of inflammation during the infection at testing on admission and after 3 weeks.Significant differences in CRP, IL6, and LDH were found in patients after 21 days' treatment.
DISCUSSION
CONCLUSIONS
Increased levels of fibrinogen and D-dimer in patients with confirmed COVID-19 have been reported in several studies. Our results showed that anti-inflammatory effects of fondaparinux and enoxaparin after 3 weeks of prophylactic treatment were similar when levels of fibrinogen and D-dimer were considered. Furthermore, levels of CRP showed a decrease in patients treated with enoxaparin and fondaparinux, although the decrease in the fondaparinux group seems to be more relevant.
Identifiants
pubmed: 33603528
doi: 10.2147/JBM.S285214
pii: 285214
pmc: PMC7886238
doi:
Types de publication
Journal Article
Langues
eng
Pagination
69-75Informations de copyright
© 2021 Cardillo et al.
Déclaration de conflit d'intérêts
The authors certify that they have no conflicts of interest to declare for this report.
Références
N Engl J Med. 2020 May 7;382(19):1787-1799
pubmed: 32187464
J Thromb Thrombolysis. 2016 Jan;41(1):32-67
pubmed: 26780738
J Thromb Haemost. 2020 Jan;18(1):180-190
pubmed: 31549765
Lancet. 2020 Mar 28;395(10229):1054-1062
pubmed: 32171076
J Thromb Haemost. 2020 Apr;18(4):844-847
pubmed: 32073213
Neth J Med. 2016 Dec;74(10):443-448
pubmed: 27966438
J Thromb Thrombolysis. 2016 May;41(4):636-43
pubmed: 26377359
J Trauma Acute Care Surg. 2012 Jan;72(1):177-82
pubmed: 22310127
Methods Enzymol. 2011;499:55-75
pubmed: 21683249
J Cardiovasc Pharmacol. 2020 Oct;76(4):369-371
pubmed: 33027192
Thromb Res. 2020 Jul;191:145-147
pubmed: 32291094
Clin Transl Sci. 2020 Nov;13(6):1087-1095
pubmed: 32881340
Curr Pharm Des. 2005;11(4):415-9
pubmed: 15725062
Medicina (Kaunas). 2020 Sep 27;56(10):
pubmed: 32992511
JAMA. 2017 Jan 17;317(3):290-300
pubmed: 28114553
Trials. 2020 Jun 26;21(1):574
pubmed: 32586394
Syst Rev. 2020 May 9;9(1):108
pubmed: 32386514
J Thromb Haemost. 2020 Oct;18(10):2629-2635
pubmed: 32692874
Thromb Res. 2021 Feb;198:34-39
pubmed: 33271421
Int J Surg. 2020 Apr;76:71-76
pubmed: 32112977
J Transl Med. 2004 Nov 09;2(1):38
pubmed: 15535889
J Allergy Clin Immunol. 2020 Jul;146(1):128-136.e4
pubmed: 32425269
J Thromb Haemost. 2009 Nov;7(11):1795-801
pubmed: 19691481
Thromb Haemost. 2020 Aug;120(8):1230-1232
pubmed: 32349132
J Clin Med. 2020 May 07;9(5):
pubmed: 32392741
Drug Discov Today. 2020 Aug;25(8):1535-1544
pubmed: 32574699
J Am Coll Cardiol. 2020 Jun 16;75(23):2950-2973
pubmed: 32311448
J Blood Med. 2020 Jul 02;11:237-241
pubmed: 32694923
Inflammopharmacology. 2019 Jun;27(3):521-529
pubmed: 29549537
Front Med (Lausanne). 2020 Nov 27;7:569567
pubmed: 33330530
PLoS One. 2015 May 11;10(5):e0126763
pubmed: 25961885