Fondaparinux Use in Patients With COVID-19: A Preliminary Multicenter Real-World Experience

Area of Science:

• Internal Medicine
• Pharmacology
• Critical Care Medicine

Background:

• Heparin use is associated with reduced mortality in severe COVID-19.
• Venous thromboembolism (VTE) is a significant concern in hospitalized COVID-19 patients.
• Anticoagulant prophylaxis is crucial for managing VTE risk.

Purpose of the Study:

• To compare the clinical impact of fondaparinux versus enoxaparin for VTE prophylaxis in COVID-19 patients.
• To evaluate differences in VTE incidence, bleeding events, ARDS, and mortality.
• To assess the safety and efficacy of fondaparinux in this patient population.

Main Methods:

• Prospective study comparing fondaparinux and enoxaparin in 100 hospitalized COVID-19 patients.
• Homogeneous groups regarding demographic, laboratory, and clinical characteristics.
• Median follow-up of 28 days, monitoring VTE, bleeding, ARDS, and mortality.

Main Results:

• No statistically significant difference in VTE incidence (14.5% vs. 5.3%; P = 0.20) between enoxaparin and fondaparinux groups.
• Similar rates of major bleeding (MB) and clinically relevant non-MB (3.2% vs. 5.3%; P = 0.76).
• Comparable incidence of ARDS (17.7% vs. 15.8%; P = 0.83) and in-hospital mortality (9.7% vs. 10.5%; P = 0.97).

Conclusions:

• Fondaparinux demonstrated comparable safety and efficacy to enoxaparin for VTE prophylaxis in hospitalized COVID-19 patients.
• Preliminary results suggest fondaparinux is a safe and effective alternative for VTE prevention in internal medicine COVID-19 units.
• Further research may confirm these findings and guide clinical practice.