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The Role of Heparin in COVID-19: An Update after Two Years of Pandemics

Marco Mangiafico1, Andrea Caff1, Luca Costanzo2

  • 1Unit of Internal Medicine, Policlinico "G. Rodolico-San Marco", 95100 Catania, Italy.

Journal of Clinical Medicine
|June 10, 2022
PubMed

Insights

This review examines heparin

Area of Science:

  • Infectious Diseases
  • Hematology
  • Pharmacology

Background:

  • COVID-19 (Coronavirus disease 2019) increases risk of venous thromboembolism (VTE) and coagulopathy.
  • SARS-CoV-2 (Severe acute respiratory syndrome coronavirus 2) infection causes endothelial damage, leading to acute and chronic complications.
  • Heparin's anticoagulant properties are beneficial in COVID-19 management.

Purpose of the Study:

  • To review evidence on heparin's efficacy in treating COVID-19 acute illness and chronic sequelae.
  • To explore heparin's potential anti-inflammatory, antiviral, and endothelial protective effects.
  • To differentiate between prophylactic and therapeutic heparin dosages for COVID-19 patients.

Main Methods:

  • Literature review of available evidence on heparin treatment in COVID-19.
  • Analysis of studies focusing on heparin's impact during acute illness and post-discharge.
  • Examination of different dosage strategies (prophylactic vs. therapeutic).

Main Results:

  • Heparin demonstrates positive impact in COVID-19 due to anticoagulation.
  • Potential anti-inflammatory and antiviral mechanisms of heparin involve Mpro and HS binding.
  • Heparin may protect vascular endothelial cells from SARS-CoV-2 induced damage.

Conclusions:

  • Heparin is a valuable therapeutic option for COVID-19 patients.
  • Understanding heparin's multifaceted actions is crucial for optimizing treatment.
  • Further research differentiating prophylactic and therapeutic dosing is warranted.

Keywords:
COVID-19coagulopathyheparinlow molecular weight heparinthromboprophylaxis

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