Impact of proactive low-molecular weight heparin therapy on outcomes in COVID-1.
COVID-19; SARS-CoV-2; thrombosis; antithrombotic therapy; low-molecular-weight heparin; D-dimer; enoxaparin.
Journal
Bratislavske lekarske listy
ISSN: 0006-9248
Titre abrégé: Bratisl Lek Listy
Pays: Slovakia
ID NLM: 0065324
Informations de publication
Date de publication:
2021
2021
Historique:
entrez:
20
7
2021
pubmed:
21
7
2021
medline:
22
7
2021
Statut:
ppublish
Résumé
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. Coronavirus disease-2019 (COVID-19) predisposes patients to arterial and venous thrombosis. 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. 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. 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).
Sections du résumé
OBJECTIVES
OBJECTIVE
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
BACKGROUND
Coronavirus disease-2019 (COVID-19) predisposes patients to arterial and venous thrombosis.
METHODS
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
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
CONCLUSIONS
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).
Identifiants
pubmed: 34282625
doi: 10.4149/BLL_2021_093
doi:
Substances chimiques
Anticoagulants
0
Heparin, Low-Molecular-Weight
0
Heparin
9005-49-6
Types de publication
Journal Article
Multicenter Study
Observational Study
Langues
eng
Sous-ensembles de citation
IM