Vergori, A;
Lorenzini, P;
Cozzi-Lepri, A;
Donno, DR;
Gualano, G;
Nicastri, E;
Iacomi, F;
... ReCOVeRI Study Group, .; + view all
(2021)
Prophylactic heparin and risk of orotracheal intubation or death in patients with mild or moderate COVID-19 pneumonia.
Scientific Reports
, 11
(1)
, Article 11334. 10.1038/s41598-021-90713-6.
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Abstract
Prophylactic low molecular weight heparin (pLMWH) is currently recommended in COVID-19 to reduce the risk of coagulopathy. The aim of this study was to evaluate whether the antinflammatory effects of pLMWH could translate in lower rate of clinical progression in patients with COVID-19 pneumonia. Patients admitted to a COVID-hospital in Rome with SARS-CoV-2 infection and mild/moderate pneumonia were retrospectively evaluated. The primary endpoint was the time from hospital admission to orotracheal intubation/death (OTI/death). A total of 449 patients were included: 39% female, median age 63 (IQR, 50–77) years. The estimated probability of OTI/death for patients receiving pLMWH was: 9.5% (95% CI 3.2–26.4) by day 20 in those not receiving pLMWH vs. 10.4% (6.7–15.9) in those exposed to pLMWH; p-value = 0.144. This risk associated with the use of pLMWH appeared to vary by PaO_{2}/FiO_{2} ratio aHR 1.40 (95% CI 0.51–3.79) for patients with an admission PaO_{2}/FiO_{2} ≤ 300 mmHg and 0.27 (0.03–2.18) for those with PaO_{2}/FiO_{2} > 300 mmHg; p-value at interaction test 0.16. pLMWH does not seem to reduce the risk of OTI/death mild/moderate COVID-19 pneumonia, especially when respiratory function had already significantly deteriorated. Data from clinical trials comparing the effect of prophylactic vs. therapeutic dosage of LMWH at various stages of COVID-19 disease are needed.
| Type: | Article |
|---|---|
| Title: | Prophylactic heparin and risk of orotracheal intubation or death in patients with mild or moderate COVID-19 pneumonia |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1038/s41598-021-90713-6 |
| Publisher version: | https://doi.org/10.1038/s41598-021-90713-6 |
| Language: | English |
| Additional information: | © 2021 Springer Nature Limited. This article is licensed under a Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/). |
| Keywords: | SARS-CoV-2, Viral infection |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health > Infection and Population Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10129525 |
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