Evidence map›Paper›PMID 32445064›Full record

ArticleJournal of thrombosis and thrombolysis2020

Heparin resistance in COVID-19 patients in the intensive care unit.

D White, S MacDonald, T Bull, M Hayman, R de Monteverde-Robb, D Sapsford, A Lavinio, J Varley, A Johnston, M Besser and 1 more

Erratum issued 2 registry-linked trialsOpen access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of thrombosis and thrombolysis, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to 2 registered trials, which are not on this map. Cited by 110 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
110citing papers in PubMed, 8 pooled it
4.2field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04466670 phase2unknown statusnot on this map

Dynamics of Hemostatic Parameters in COVID-19 and Comparison of Intervention Strategies Through Adaptive Clinical Trial

TypeinterventionalSponsorUniversity of Sao Paulo General HospitalRan2020 to 2022Enrolled379ConditionsCOVID-19Armsacetylsalicylic acid, Unfractionated heparin nebulized
NCT05509647 completednot on this map

Unfractionated Heparin in COVID-19 and Non-COVID-19 Patients - an Observational Study.

TypeobservationalSponsorLeiden University Medical CenterRan2014 to 2022Enrolled1,500ConditionsHeparin Overdose of Undetermined Intent, COVID-19ArmsUnfractionated heparin
3 · Its place in the literature

Who cites it

110 citing papers in PubMed, 8 syntheses or guidelines pooled it, 182 citations in OpenAlex.

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50 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 1 institution in 1 country.

D WhiteDepartment of Haematology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
S MacDonaldDepartment of Haematology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
T BullDepartment of Haematology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
M HaymanDepartment of Haematology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
R de Monteverde-RobbPharmacy Department, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
D SapsfordPharmacy Department, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
A LavinioDepartment of Intensive Care Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
J VarleyDepartment of Intensive Care Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
A JohnstonDepartment of Intensive Care Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
M BesserDepartment of Haematology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
W ThomasDepartment of Haematology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK. william.thomas@addenbrookes.nhs.uk.ORCID http://orcid.org/0000-0001-6969-3173
Cambridge University Hospitals NHS Foundation Trust · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Patients with COVID-19 have a coagulopathy and high thrombotic risk. In a cohort of 69 intensive care unit (ICU) patients we investigated for evidence of heparin resistance in those that have received therapeutic anticoagulation. 15 of the patients have received therapeutic anticoagulation with either unfractionated heparin (UFH) or low molecular weight heparin (LMWH), of which full information was available on 14 patients. Heparin resistance to UFH was documented in 8/10 (80%) patients and sub-optimal peak anti-Xa following therapeutic LMWH in 5/5 (100%) patients where this was measured (some patients received both anticoagulants sequentially). Spiking plasma from 12 COVID-19 ICU patient samples demonstrated decreased in-vitro recovery of anti-Xa compared to normal pooled plasma. In conclusion, we have found evidence of heparin resistance in critically unwell COVID-19 patients. Further studies investigating this are required to determine the optimal thromboprophylaxis in COVID-19 and management of thrombotic episodes.

Indexed as

Drug ResistanceIntensive Care UnitsAdultAgedAnticoagulantsBetacoronavirusBlood CoagulationBlood Coagulation TestsCoronavirus InfectionsCOVID-19Drug MonitoringFemaleHeparinHost-Pathogen InteractionsHumansMaleAnticoagulantsHeparinCOVID-19HeparinIntensive careThrombosis

Identifiers

PMID32445064
PMCPMC7242778
OpenAlexW3026400664

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.