Clinical study of anticoagulant therapy in patients with severe coronavirus disease: A single-center retrospective analysis

Autor: Peng Zhou, Chuan-Qi Cai, Jin-Song Li, Huan-Zong Jiang, Zun-Xiang Ke, Shan Zhang, Zhong-Jian Wang, Chao Yang, Qin Li, Yi-Qing Li
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Vascular Investigation and Therapy, Vol 4, Iss 2, Pp 40-45 (2021)
Druh dokumentu: article
ISSN: 2589-9686
2589-9481
DOI: 10.4103/VIT-D-21-00010
Popis: OBJECTIVE: The prognosis of COVID-19 is related to thrombotic events. This study investigated prognostic risk factors, anticoagulant therapy effects, and potential instruction of treatment or prognostic with D-dimer in patients with severe COVID-19 receiving anticoagulant therapy. MATERIALS AND METHODS: We undertook a retrospective study of 87 severe COVID-19 patients who had prophylactic low-molecular-weight heparin (LMWH) therapy. Patients were divided into two groups according to whether high-flow oxygen therapy was required during hospitalization: Better and poor prognoses. RESULTS: Multivariate logistic regression using risk factors measured before LMWH therapy revealed that older age (P < 0.035) and higher C-reactive protein (CRP) levels (P = 0.002) had a prognostic value. Anticoagulant therapy yielded significant changes in CRP levels (P < 0.001), white blood cell counts (P = 0.001), neutrophil counts (P < 0.001), neutrophil/lymphocyte ratios (P < 0.001), eosinophil counts (P = 0.031), and D-dimer levels (P < 0.001) in the better prognosis group and in D-dimer levels (P = 0.043) only in the poor prognosis group. Prognoses at different D-dimer levels at anticoagulant therapy initiation varied. Among 47 and 40 patients with D-dimer levels ≤4 and >4 μg/ml fibrin equivalent unit (FEU), 33 (70.6%) and 18 (45%) had better prognosis (P = 0.012), respectively. CONCLUSION: Anticoagulant therapy reduced inflammation in patients with better prognosis; conversely, minimal effect was observed in those with poor prognosis. During LMWH therapy patients with D-dimer levels, patients receiving anticoagulant therapy at D-dimer levels ≤4 μg/ml FEU had a better prognosis than those at >4 μg/ml FEU.
Databáze: Directory of Open Access Journals
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