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Clinical outcome with different doses of low-molecular-weight heparin in patients hospitalized for COVID-19.
- 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 (>ā4000 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=ā0.664). 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).)
- Subjects :
- Aged
Aged, 80 and over
Anticoagulants adverse effects
COVID-19 blood
COVID-19 diagnosis
COVID-19 mortality
Enoxaparin adverse effects
Female
Hospital Mortality
Humans
Italy
Male
Middle Aged
Protective Factors
Respiration, Artificial
Retrospective Studies
Risk Assessment
Risk Factors
Thromboembolism blood
Thromboembolism diagnosis
Thromboembolism mortality
Time Factors
Treatment Outcome
Anticoagulants administration & dosage
COVID-19 therapy
Enoxaparin administration & dosage
Hospitalization
Thromboembolism prevention & control
Subjects
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