Clinical outcome with different doses of low-molecular-weight heparin in patients hospitalized for COVID-19.
J Thromb Thrombolysis
; 52(3): 782-790, 2021 Oct.
Статья
в английский
| MEDLINE | ID: covidwho-1111318
ABSTRACT
A pro-thrombotic milieu and a higher risk of thrombotic events were observed in patients with CoronaVirus disease-19 (COVID-19). Accordingly, recent data suggested a beneficial role of low molecular weight heparin (LMWH), but the optimal dosage of this treatment is unknown. We evaluated the association between prophylactic vs. intermediate-to-fully anticoagulant doses of enoxaparin and in-hospital adverse events in patients with COVID-19. We retrospectively included 436 consecutive patients admitted in three Italian hospitals. Outcome according to the use of prophylactic (4000 IU) vs. higher (> 4000 IU) daily dosage of enoxaparin was evaluated. The primary end-point was in-hospital death. Secondary outcome measures were in-hospital cardiovascular death, venous thromboembolism, new-onset acute respiratory distress syndrome (ARDS) and mechanical ventilation. A total of 287 patients (65.8%) were treated with the prophylactic enoxaparin regimen and 149 (34.2%) with a higher dosing regimen. The use of prophylactic enoxaparin dose was associated with a similar incidence of all-cause mortality (25.4% vs. 26.9% with the higher dose; OR at multivariable analysis, including the propensity score 0.847, 95% CI 0.400-0.1.792; p = 0.664). In the prophylactic dose group, a significantly lower incidence of cardiovascular death (OR 0.165), venous thromboembolism (OR 0.067), new-onset ARDS (OR 0.454) and mechanical intubation (OR 0.150) was observed. In patients hospitalized for COVID-19, the use of a prophylactic dosage of enoxaparin appears to be associated with similar in-hospital overall mortality compared to higher doses. These findings require confirmation in a randomized, controlled study.
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Имеется в наличии
Коллекция:
Международные базы данных
база данных:
MEDLINE
Основная тема:
Thromboembolism
/
Enoxaparin
/
COVID-19
/
Hospitalization
/
Anticoagulants
Тип исследования:
Диагностическое исследование
/
Экспериментальные исследования
/
Наблюдательное исследование
/
Прогностическое исследование
/
Рандомизированные контролируемые испытания
Пределы темы:
Пожилые
/
Женщины
/
Люди
/
Мужчины
/
Middle aged
Страна как тема:
Европа
Язык:
английский
Журнал:
J Thromb Thrombolysis
Тематика журнала:
Болезни системы кровообращения
Год:
2021
Тип:
Статья
Аффилированная страна:
S11239-021-02401-x
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