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Rapid Point-of-Care Assay of Enoxaparin Anticoagulant Efficacy in Whole Blood
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Is therapeutic anticoagulation improving renal outcomes in COVID-19?

Sohaib Roomi1, Waqas Ullah1, Soban Farooq2

  • 1Department of Internal Medicine, Jefferson Health Abington, Abington, PA, USA.

Journal of Community Hospital Internal Medicine Perspectives
|August 28, 2020
PubMed

Insights

Therapeutic anticoagulation with heparin improved kidney function in three COVID-19 patients with acute renal failure. Stopping anticoagulation led to worsening kidney function, suggesting a link between heparin and renal recovery in these cases.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Hematology

Background:

  • COVID-19 is associated with a hypercoagulable state.
  • Acute kidney injury (AKI) is a known complication of severe COVID-19.
  • The exact mechanisms linking COVID-19, thrombosis, and AKI require further investigation.

Purpose of the Study:

  • To investigate the potential benefit of therapeutic anticoagulation in COVID-19 patients experiencing acute renal failure.
  • To explore the relationship between anticoagulation, kidney function, and inflammatory markers in this patient cohort.

Main Methods:

  • Case series presentation of three patients with COVID-19 and acute renal failure.
  • Administration of therapeutic anticoagulation using heparin with a target activated partial thromboplastin time (aPTT) of 58-93 seconds.
  • Monitoring of renal function (serum creatinine, estimated glomerular filtration rate), D-dimer levels, and other inflammatory markers.

Main Results:

  • All three patients showed significant improvement in kidney function after initiating heparin anticoagulation.
  • One patient experienced a decline in renal function upon cessation of anticoagulation.
  • D-dimer levels decreased with anticoagulation, while other inflammatory markers showed unpredictable trends.

Conclusions:

  • Therapeutic anticoagulation with heparin may be beneficial in improving renal function in select COVID-19 patients with acute kidney injury.
  • A temporal relationship between anticoagulation initiation and kidney function improvement was observed.
  • Further research is warranted to elucidate the role of anticoagulation in COVID-19-associated nephropathy.

Keywords:
Anticoagulationatrial fibrillationrenal failure

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