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Risk Benefit Analysis in Reference to use of LMWH in COVID-19

Shambo Samrat Samajdar1, Priya Ann Sam2, Saibal Moitra3

  • 1DM Resident in Clinical Pharmacology, School of Tropical Medicine, Kolkata.

The Journal of the Association of Physicians of India
|August 17, 2020
PubMed

Insights

Low molecular weight heparin (LMWH) offers a favorable risk-benefit profile for preventing blood clots in hospitalized COVID-19 patients. This analysis supports LMWH for thrombosis prophylaxis in severe cases, improving patient outcomes.

Area of Science:

  • Cardiology
  • Hematology
  • Infectious Diseases

Background:

  • COVID-19 infection frequently leads to cardiovascular and respiratory complications, including venous thromboembolism (VTE) and disseminated intravascular coagulation (DIC).
  • A prothrombotic state, characterized by elevated fibrin, fibrin degradation products, fibrinogen, and D-dimers, is associated with COVID-19.
  • Heparin therapy has been considered for COVID-19 patients due to the risks of VTE and DIC.

Purpose of the Study:

  • To conduct a risk-benefit analysis of using low molecular weight heparin (LMWH) for thrombosis prophylaxis in hospitalized COVID-19 patients.
  • To evaluate the safety and efficacy of LMWH in the context of COVID-19-associated coagulopathy.

Main Methods:

  • Review of clinical evidence and case studies.
  • Analysis of safety aspects concerning LMWH use in COVID-19 patients.
  • Assessment of heparin's role in managing COVID-19 complications.

Main Results:

  • COVID-19 is linked to inflammation and a prothrombotic state, increasing clotting risks.
  • Heparin treatment, including LMWH, appears to correlate with improved prognosis in severe COVID-19 patients with coagulopathy.
  • Studies indicate better outcomes for severe COVID-19 patients receiving LMWH for thrombosis prophylaxis, especially those with elevated D-dimer levels.

Conclusions:

  • LMWH demonstrates a potentially favorable risk-benefit profile for thrombosis prophylaxis in COVID-19 patients.
  • The use of LMWH is supported by clinical evidence for improving prognosis in severe COVID-19 with coagulopathy.
  • Further investigation into heparin's role in managing COVID-19 complications is warranted.

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