Thrombosis and Coagulopathy in COVID-19

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Juan Esteban Gómez-Mesa, Stephania Galindo-Coral, Maria Claudia Montes

    Current Problems in Cardiology
    |November 27, 2020
    PubMed

    Insights

    Early anticoagulant treatment with low molecular weight heparin significantly improves outcomes for severe COVID-19 patients. This intervention reduces mortality and enhances oxygen levels by preventing dangerous blood clots.

    Area of Science:

    • Medicine
    • Infectious Diseases
    • Critical Care

    Background:

    • The COVID-19 pandemic, declared by the WHO in March 2020, has led to significant global health challenges.
    • Severe COVID-19 cases are associated with a high mortality rate (42%), particularly in patients with comorbidities and elevated coagulation markers.
    • Markers such as Sepsis Induced Coagulopathy score, D-dimer, C-reactive protein, and troponins indicate a worse prognosis.

    Purpose of the Study:

    • To evaluate the impact of early anticoagulant therapy on mortality and clinical outcomes in hospitalized patients with severe COVID-19.
    • To investigate the potential of low molecular weight heparin in mitigating pulmonary coagulopathy and improving oxygenation.

    Main Methods:

    • Observational analysis of hospitalized severe COVID-19 patients.
    • Assessment of outcomes in patients receiving initial anticoagulant treatment with low molecular weight heparin compared to those not receiving it.
    • Monitoring of mortality rates at 7 and 28 days, and changes in arterial oxygen pressure/inspired fraction of O2 (PaO2/FiO2) ratio.

    Main Results:

    • Initial anticoagulant treatment with low molecular weight heparin demonstrated a significant reduction in mortality.
    • Mortality decreased by 48% at 7 days and 37% at 28 days in patients receiving heparin.
    • Significant improvement in the PaO2/FiO2 ratio was observed, indicating better lung function.

    Conclusions:

    • Early administration of low molecular weight heparin is associated with improved survival rates in severe COVID-19.
    • Anticoagulant therapy effectively mitigates microthrombi formation and pulmonary coagulopathy, leading to better oxygenation.
    • Low molecular weight heparin represents a valuable therapeutic strategy for managing severe COVID-19 complications.

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