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Heparin for patients with coronavirus disease 2019 and hypercoagulation complications: A cohort study

Muhammad Fachri1, Mochammad Hatta2, Sefia Nabila Nur Azmi Tarigan1

  • 1Department of Pulmonology and Respiratory Medicine, Faculty of Medicine and Health, Universitas Muhammadiyah Jakarta, Jakarta, Indonesia.

Annals of Medicine and Surgery (2012)
|July 5, 2022
PubMed

Insights

This study compared unfractionated heparin (UFH) and low molecular weight heparin (LMWH) for COVID-19 thrombotic complications. LMWH showed a trend towards greater D-dimer reduction in hospitalized patients.

Area of Science:

  • Critical Care Medicine
  • Hematology
  • Infectious Diseases

Background:

  • Thrombotic complications are a significant concern in coronavirus disease 2019 (COVID-19), particularly in critically ill patients.
  • These complications are associated with poor clinical outcomes, necessitating effective anticoagulation strategies.

Purpose of the Study:

  • To compare the efficacy of unfractionated heparin (UFH) and low molecular weight heparin (LMWH) in managing hypercoagulable complications in hospitalized COVID-19 patients.
  • To evaluate the impact of different heparin types on key coagulation markers.

Main Methods:

  • A retrospective cohort study design was employed.
  • Data were extracted from medical records of hospitalized patients with confirmed COVID-19, including pre- and post-treatment measurements.
  • Patients were divided into two groups: those receiving UFH and those receiving LMWH (fondaparinux).

Main Results:

  • The study included 98 patients (52% women, 30.6% over 60 years).
  • A greater decrease in D-dimer levels was observed in the UFH group (34.3% of patients) compared to the LMWH group (23.8% of patients).
  • COVID-19 patients exhibited increased D-dimer and fibrinogen, with normal prothrombin time and activated partial thromboplastin clotting time.

Conclusions:

  • A significant relationship was found between D-dimer and prothrombin time in COVID-19 inpatients.
  • While both UFH and LMWH were used, the study suggests a potential trend in D-dimer reduction favoring UFH, warranting further investigation.
  • Hypercoagulable states characterized by elevated D-dimer and fibrinogen are common in COVID-19.
Abstract

Keywords:
COVID-19D-dimerHeparinHypercoagulationLMWH (Fondaparinux)

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