Comparison of the Effect of Unfractionated Heparin and Enoxaparin Sodium at Different Doses on the Course of COVID-19-Associated Coagulopathy.

Autor: Oliynyk O; Department of Anaesthesiology and Intensive Care, Bogomolets National Medical University, 01601 Kyiv, Ukraine.; Department of Emergency Medicine, Pope John II State School of Higher Education in Biala Podlaska, 21-500 Biala Podlaska, Poland., Barg W; Department of Internal Medicine, Pneumonology and Allergology, Wroclaw Medical University, 50-367 Wroclaw, Poland., Slifirczyk A; Department of Emergency Medicine, Pope John II State School of Higher Education in Biala Podlaska, 21-500 Biala Podlaska, Poland., Oliynyk Y; Department of Immunology and Allergology, Bogomolets National Medical University, 01601 Kyiv, Ukraine., Dubrov S; Department of Anaesthesiology and Intensive Care, Bogomolets National Medical University, 01601 Kyiv, Ukraine., Gurianov V; Department of Medical Statistics, Bogomolets National Medical University, 01601 Kyiv, Ukraine., Rorat M; Department of Forensic Medicine, Wroclaw Medical University, 50-367 Wroclaw, Poland.
Jazyk: angličtina
Zdroj: Life (Basel, Switzerland) [Life (Basel)] 2021 Sep 30; Vol. 11 (10). Date of Electronic Publication: 2021 Sep 30.
DOI: 10.3390/life11101032
Abstrakt: Background: COVID-19-associated coagulopathy (CAC) exacerbates the course of coronavirus infection and contributes to increased mortality. Current recommendations for CAC treatment include the use of low-molecular weight heparins (LMWH) at prophylactic or therapeutic doses, as well as the use of unfractionated heparin (UFH).
Methods: A randomised, controlled trial enrolled 126 patients hospitalised in the intensive care unit with severe COVID-19 complicated by CAC. The effects of LMWH at preventive and therapeutic doses and UFH at therapeutic doses on mortality and intubation rates were compared.
Results: The number of intubations and deaths showed no significant difference depending on the anticoagulant therapy used. However, multivariate logistic regression models revealed an increased risk of intubation ( p = 0.026, odds ratio (OR) = 3.33, 95% confidence interval (CI) 1.15-9.59), and an increased risk of death ( p = 0.046, OR = 3.01, 95% CI 1.02-8.90), for patients treated with LMWH at a prophylactic dose but not at a therapeutic dose as compared to patients treated with UFH when controlling for other risk factors.
Conclusions: The use of unfractionated heparin in the treatment of COVID-19-associated coagulopathy seems to be more effective at reducing the risk of intubation and death than enoxaparin at prophylactic doses.
Databáze: MEDLINE
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