ArticleJournal of vascular surgery. Venous and lymphatic disorders2022
Low-molecular-weight heparin compared with unfractionated heparin in critically ill COVID-19 patients.
Article in Journal of vascular surgery. Venous and lymphatic disorders, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Impacts of COVID-19 on hemostasis: coagulation abnormalities and management perspectives.Annals of medicine and surgery (2012) · 2024Review
- The Preventive and Therapeutic Effects of Acute and Severe Inflammatory Disorders with Heparin and Heparinoid.Biomolecules · 2024Review
- Venous thromboembolism in hospitalized coronavirus disease 2019 patients stratified by vaccination status.Journal of vascular surgery. Venous and lymphatic disorders · 2023Article
- Impact of vaccination status and anticoagulation on venous thromboembolism risk and outcomes in coronavirus disease 2019 patients.Journal of vascular surgery. Venous and lymphatic disorders · 2023Article
- Low molecular weight heparin in COVID-19: benefits and concerns.Frontiers in pharmacology · 2023Review
- The Use of Coagulation Markers to Evaluate the Effectiveness of Coronavirus Disease (COVID-19) Therapeutic Protocols.Materia socio-medica · 2023Article
- COVID-19 Treatment-Current Status, Advances, and Gap.Pathogens (Basel, Switzerland) · 2022Review
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Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThrombosis in COVID-19 worsens mortality. In our study, we sought to investigate how the dose and type of anticoagulation (AC) can influence patient outcomes.
methodsThis is a single-center retrospective analysis of critically ill intubated patients with COVID-19, comparing low-molecular-weight heparin (LMWH) and unfractionated heparin (UFH) at therapeutic and prophylactic doses. Of 218 patients, 135 received LMWH (70 prophylactic, 65 therapeutic) and 83 UFH (11 prophylactic, 72 therapeutic). The primary outcome was mortality. Secondary outcomes were thromboembolic complications confirmed on imaging and major bleeding complications. Cox proportional-hazards regression models were used to determine whether the type and dose of AC were independent predictors of survival. We performed Kaplan-Meier survival analysis to compare the cumulative survivals.
resultsOverall, therapeutic AC, with either LMWH (65% vs 79%, P = .09) or UFH (32% vs 46%, P = .73), conveyed no survival benefit over prophylactic AC. UFH was associated with a higher mortality rate than LMWH (66% vs 28%, P = .001), which was also evident in the multivariable analysis (LMWH vs UFH mortality, hazard ratio: 0.47, P = .001) and in the Kaplan-Meier survival analysis. Thrombotic and bleeding complications did not depend on the AC type (prophylactic LMWH vs UFH: thrombosis P = .49, bleeding P = .075; therapeutic LMWH vs UFH: thrombosis P = .5, bleeding P = .17). When comparing prophylactic with therapeutic AC, the rate of both thrombotic and bleeding complications was higher with the use of LMWH compared with UFH. In addition, transfusion requirements were significantly higher with both therapeutic LMWH and UFH.
conclusionsAmong intubated critically ill COVID-19 intensive care unit patients, therapeutic AC, with either LMWH or UFH, conveyed no survival benefit over prophylactic AC. AC with LMWH was associated with higher cumulative survival compared with AC with UFH.
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