Impact of proactive low-molecular weight heparin therapy on outcomes in COVID-19


Görmez S. , Kurtoğlu Gümüşel H., Ekıcıbası M. E. , Değirmencioğlu A. , Paudel A. , Akan G., ...More

Bratislava Medical Journal-Bratislavske Lekarske Listy, vol.122, no.8, pp.582-589, 2021 (Journal Indexed in SCI Expanded)

  • Publication Type: Article / Article
  • Volume: 122 Issue: 8
  • Publication Date: 2021
  • Doi Number: 10.4149/bll_2021_093
  • Title of Journal : Bratislava Medical Journal-Bratislavske Lekarske Listy
  • Page Numbers: pp.582-589

Abstract

Abstract: OBJECTIVES: 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: Coronavirus disease-2019 (COVID-19) predisposes patients to arterial and venous thrombosis.

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: 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: 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).