ArticleInternational journal of laboratory hematology2021
Heparin dosage, level, and resistance in SARS-CoV2 infected patients in intensive care unit.
Article in International journal of laboratory hematology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 32 citations in OpenAlex.
- Efficacy and Safety of Direct Oral Anticoagulants Compared With Heparin for Preventing Thromboembolism in Hospitalized Patients With COVID-19: A Systematic Review and Meta-Analysis.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisPooled it
- Case Report: Extracorporeal membrane oxygenation in acute coronary syndrome: a rare case of massive left ventricular thrombus.Frontiers in cardiovascular medicine · 2026Article
- Update on Anticoagulation Strategies in Patients with ECMO-A Narrative Review.Journal of clinical medicine · 2023Review
- Viral anti-inflammatory serpin reduces immuno-coagulopathic pathology in SARS-CoV-2 mouse models of infection.EMBO molecular medicine · 2023Article
- Resistance to unfractionated heparin in the ICU: evaluation and management options.Intensive care medicine · 2023Article
- Pulmonary Thrombosis despite Therapeutic Anticoagulation in COVID-19 Pneumonia: A Case Report and Literature Review.Viruses · 2023Review
- Development of a Decision Support Tool for Anticoagulation in Critically Ill Patients Admitted for SARS-CoV-2 Infection: The CALT Protocol.Biomedicines · 2023Article
- Anticoagulation Management during Extracorporeal Membrane Oxygenation-A Mini-Review.Medicina (Kaunas, Lithuania) · 2022Review
- Heparin Resistance in SARS-CoV-2 Infected Patients with Venous Thromboembolism.Hospital pharmacy · 2022Article
- Effect of intermediate/high versus low dose heparin on the thromboembolic and hemorrhagic risk of unvaccinated COVID-19 patients in the emergency department.BMC emergency medicine · 2022Article
- Regenerable and high-throughput surface plasmon resonance assay for rapid screening of anti-SARS-CoV-2 antibody in serum samples.Analytica chimica acta · 2022Article
- Serial thrombin generation and exploration of alternative anticoagulants in critically ill COVID-19 patients: Observations from Maastricht Intensive Care COVID Cohort.Frontiers in cardiovascular medicine · 2022Article
- Heparin dosage, level, and resistance in SARS-CoV2 infected patients in intensive care unit.International journal of laboratory hematology · 2021Article
- Intermediate-to-therapeutic versus prophylactic anticoagulation for coagulopathy in hospitalized COVID-19 patients: a systemic review and meta-analysis.Thrombosis journal · 2021Article
- Research on SARS-COV-2 pandemic: a narrative review focused on the Italian contribution.Journal of anesthesia, analgesia and critical care · 2021Review
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- High-value laboratory testing for hospitalized COVID-19 patients: a review.Future virology · 2021Review
- Understanding COVID-19-related myocarditis: pathophysiology, diagnosis, and treatment strategies.Cardiology plusReview
- Factor VIII, Fibrinogen and Heparin Resistance in COVID-19 Patients with Thromboembolism: How Should We Manage the Anticoagulation Therapy?Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisArticle
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionPatients with COVID-19 frequently exhibit a hypercoagulable state with high thrombotic risk, particularly those admitted to intensive care units (ICU). Thromboprophylaxis is mandatory in these patients; nevertheless, thrombosis still occurs in many cases. Thus, the problem of assessing an adequate level of anticoagulation in ICU patients becomes evident during the COVID-19 pandemic. The aim of this study was to evaluate the heparin resistance and the efficacy of heparin monitoring using an anti-Xa activity assay.
methodsThirty-seven heparin-treated patients admitted to ICU for SARS-CoV-2 pneumonia were retrospectively studied for antifactor Xa activity (anti-Xa), activated partial thromboplastin time (APTT), Antithrombin, Fibrinogen, D-Dimer, Factor VIII, von Willebrand Factor, and the total daily amount of heparin administered. The correlation between APTT and anti-Xa was evaluated for unfractionated heparins (UFH). The correlations between the daily dose of UFH or the dosage expressed as IU/kg b.w. for low molecular weight heparin (LMWH) and anti-Xa were also evaluated.
resultsTwenty-one patients received calcium heparin, 8 sodium heparin, and 8 LMWH. A moderate correlation was found between APTT and anti-Xa for UFH. APTT did not correlate with coagulation parameters. 62% of UFH and 75% of LMWH treated patients were under the therapeutic range. About 75% of patients could be considered resistant to heparin.
conclusionsSARS-COV2 pneumonia patients in ICU have frequently heparin resistance. Anti-Xa seems a more reliable method to monitor heparin treatment than APTT in acute patients, also because the assay is insensitive to the increased levels of fibrinogen, FVIII, and LAC that are common during the COVID-19 inflammatory state.
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