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Impact of proactive low-molecular weight heparin therapy on outcomes in COVID-1

S Gormez, H K Gumusel, E Ekicibasi

    Bratislavske Lekarske Listy
    |July 20, 2021
    PubMed

    Insights

    Proactive treatment with low molecular weight heparin (LMWH) in COVID-19 patients, even with normal D-dimer levels, significantly improves clinical outcomes. Early LMWH administration showed the best results, reducing hospitalization and mortality risks.

    Area of Science:

    • Critical care medicine
    • Hematology
    • Infectious diseases

    Background:

    • COVID-19 is associated with an increased risk of thrombosis.
    • Understanding thrombotic risk factors in COVID-19 is crucial for effective treatment.
    • D-dimer levels can indicate thrombotic activity in COVID-19 patients.

    Purpose of the Study:

    • To evaluate the impact of low molecular weight heparin (LMWH) on clinical outcomes in COVID-19 patients.
    • To determine if LMWH is beneficial for patients with normal D-dimer levels at admission.
    • To compare outcomes between early prophylactic LMWH, delayed LMWH, and no LMWH treatment.

    Main Methods:

    • Retrospective, multicentre, observational study of 308 COVID-19 patients.
    • Propensity score matching (PSM) was used to create comparable groups.
    • Groups included: LMWH with D-dimer ≤0.5 mg/L, LMWH after D-dimer >0.5 mg/L, and no LMWH.

    Main Results:

    • After PSM, 40 patients were in each group.
    • Patients receiving early prophylactic LMWH (Group 1) had the best clinical outcomes.
    • The group receiving no LMWH (Group 3) exhibited the worst clinical outcomes (p<0.005).
    • Benefits of LMWH were most pronounced when initiated early, with D-dimer levels ≤0.5 mg/L.

    Conclusions:

    • Proactive LMWH therapy significantly improves clinical outcomes in hospitalized COVID-19 patients.
    • Early LMWH administration is recommended, even in patients with normal D-dimer levels (≤0.5 mg/L).
    • LMWH treatment demonstrates a clear benefit in managing COVID-19 complications related to thrombosis.
    Abstract

    Keywords:
    COVID-19; SARS-CoV-2; thrombosis; antithrombotic therapy; low-molecular-weight heparin; D-dimer; enoxaparin.

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