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Clinical outcome with different doses of low-molecular-weight heparin in patients hospitalized for COVID-19.

Authors :
Mennuni MG
Renda G
Grisafi L
Rognoni A
Colombo C
Lio V
Foglietta M
Petrilli I
Pirisi M
Spinoni E
Azzolina D
Hayden E
Aimaretti G
Avanzi GC
Bellan M
Cantaluppi V
Capponi A
Castello LM
D'Ardes D
Corte FD
Gallina S
Krengli M
Malerba M
Pierdomenico SD
Savoia P
Zeppegno P
Sainaghi PP
Cipollone F
Patti G
Source :
Journal of thrombosis and thrombolysis [J Thromb Thrombolysis] 2021 Oct; Vol. 52 (3), pp. 782-790. Date of Electronic Publication: 2021 Mar 01.
Publication Year :
2021

Abstract

A pro-thrombotic milieu and a higher risk of thrombotic events were observed in patients with CoronaVirus disease-19 (COVID-19). Accordingly, recent data suggested a beneficial role of low molecular weight heparin (LMWH), but the optimal dosage of this treatment is unknown. We evaluated the association between prophylactic vs. intermediate-to-fully anticoagulant doses of enoxaparin and in-hospital adverse events in patients with COVID-19. We retrospectively included 436 consecutive patients admitted in three Italian hospitals. Outcome according to the use of prophylactic (4000 IU) vs. higher (>ā€‰4000 IU) daily dosage of enoxaparin was evaluated. The primary end-point was in-hospital death. Secondary outcome measures were in-hospital cardiovascular death, venous thromboembolism, new-onset acute respiratory distress syndrome (ARDS) and mechanical ventilation. A total of 287 patients (65.8%) were treated with the prophylactic enoxaparin regimen and 149 (34.2%) with a higher dosing regimen. The use of prophylactic enoxaparin dose was associated with a similar incidence of all-cause mortality (25.4% vs. 26.9% with the higher dose; OR at multivariable analysis, including the propensity score: 0.847, 95% CI 0.400-0.1.792; pā€‰=ā€‰0.664). In the prophylactic dose group, a significantly lower incidence of cardiovascular death (OR 0.165), venous thromboembolism (OR 0.067), new-onset ARDS (OR 0.454) and mechanical intubation (OR 0.150) was observed. In patients hospitalized for COVID-19, the use of a prophylactic dosage of enoxaparin appears to be associated with similar in-hospital overall mortality compared to higher doses. These findings require confirmation in a randomized, controlled study.<br /> (© 2021. The Author(s).)

Details

Language :
English
ISSN :
1573-742X
Volume :
52
Issue :
3
Database :
MEDLINE
Journal :
Journal of thrombosis and thrombolysis
Publication Type :
Academic Journal
Accession number :
33649979
Full Text :
https://doi.org/10.1007/s11239-021-02401-x