Low molecular weight heparin in COVID-19: benefits and concerns

Article Cardiac & Cardiovascular Systems

The Association of Low Molecular Weight Heparin Use and In-hospital Mortality Among Patients Hospitalized with COVID-19

Lan Shen et al.

Summary: The study found that the use of LMWH in hospitalized COVID-19 patients was associated with lower all-cause in-hospital mortality compared to non-LMWH users, especially among more severely ill patients.

CARDIOVASCULAR DRUGS AND THERAPY (2022)

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Article Hematology

Intermediate-Dose versus Standard-Dose Prophylactic Anticoagulation in Patients with COVID-19 Admitted to the Intensive Care Unit: 90-Day Results from the INSPIRATION Randomized Trial

Behnood Bikdeli et al.

Summary: A study showed that intermediate-dose compared with standard-dose prophylactic anticoagulation did not reduce the risk of death, treatment with ECMO, or venous or arterial thrombosis in critically ill patients with COVID-19 at 90-day follow-up.

THROMBOSIS AND HAEMOSTASIS (2022)

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Article Biochemistry & Molecular Biology

Coagulopathy and Fibrinolytic Pathophysiology in COVID-19 and SARS-CoV-2 Vaccination

Shinya Yamada et al.

Summary: COVID-19, caused by SARS-CoV-2, often leads to thrombosis. Attention should be paid to both coagulation activation and fibrinolytic activation in the treatment of COVID-19. Vaccination with SARS-CoV-2 vaccines may result in various thrombotic complications. Vaccine-induced immune thrombotic thrombocytopenia (VITT) is characterized by the presence of anti-platelet factor 4 antibodies and thrombosis in unusual locations. Evaluation of coagulation activation and fibrinolytic activation is important for the treatment of VITT, with adjustments made accordingly for improved outcomes.

INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES (2022)

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Review Pharmacology & Pharmacy

Aspirin in COVID-19: Pros and Cons

Rana Zareef et al.

Summary: The COVID-19 pandemic has had a significant impact on medical and economic sectors. Severe cases of the disease can lead to life-threatening complications. Aspirin, with its anti-inflammatory and anti-platelet effects, has been considered as a potential therapeutic agent, but more clinical evidence is needed.

FRONTIERS IN PHARMACOLOGY (2022)

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Article Medicine, General & Internal

The effect of low-dose and high-dose low-molecular-weight-heparin and aspirin thromboprophylaxis on clinical outcome and mortality in critical ill patients with COVID-19 A retrospective cohort study

Ali Eman et al.

Summary: This study assessed the effects of different thromboprophylaxis regimens on clinical outcomes and mortality of critically ill COVID-19 patients. The results showed that high-dose anticoagulation therapy and addition of aspirin to LMWH therapy did not decrease mortality rates and length of stay in ICU. Moreover, it did not increase the incidence of major hemorrhage and major thrombotic events.

SAUDI MEDICAL JOURNAL (2022)

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Article Hematology

Thromboprophylactic low-molecular-weight heparin versus standard of care in unvaccinated, at-risk outpatients with COVID-19 (ETHIC): an open-label, multicentre, randomised, controlled, phase 3b trial

Frank Cools et al.

Summary: The study results suggest that prophylaxis with low-molecular-weight heparin had no benefit for at-risk outpatients with COVID-19.

LANCET HAEMATOLOGY (2022)

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Article Surgery

Low-molecular-weight heparin compared with unfractionated heparin in critically ill COVID-19 patients

Panagiotis Volteas et al.

Summary: Among critically ill COVID-19 patients in the intensive care unit who required intubation, therapeutic anticoagulation with either LMWH or UFH showed no survival benefit compared to prophylactic anticoagulation. LMWH was associated with higher cumulative survival compared to UFH. The type of anticoagulation did not affect the incidence of thrombotic and bleeding complications.

JOURNAL OF VASCULAR SURGERY-VENOUS AND LYMPHATIC DISORDERS (2022)

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Article Hematology

Intermediate-dose anticoagulation, aspirin, and in-hospital mortality in COVID-19: A propensity score-matched analysis

Matthew L. Meizlish et al.

Summary: In this study of hospitalized COVID-19 patients, intermediate-dose anticoagulation and aspirin treatment were each associated with a significantly lower cumulative incidence of in-hospital death as shown by propensity score matching and multivariable regression analysis.

AMERICAN JOURNAL OF HEMATOLOGY (2021)

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Article Cardiac & Cardiovascular Systems

Impact of oral anticoagulation on clinical outcomes of COVID-19: a nationwide cohort study of hospitalized patients in Germany

Georg M. Froehlich et al.

Summary: This study investigated the impact of concomitant long-term medication on clinical outcomes in hospitalized COVID-19 patients. The use of oral anticoagulants was associated with improved outcomes, while ACE inhibitors did not impact outcomes. Prospective randomized trials are needed to verify these findings.

CLINICAL RESEARCH IN CARDIOLOGY (2021)

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Article Medicine, General & Internal

Increasing dosages of low-molecular-weight heparin in hospitalized patients with Covid-19

Ida Martinelli et al.

Summary: The study showed a 60% reduction in mortality and clinical deterioration, and a 50% reduction in venous thromboembolism in Covid-19 patients treated with high doses of enoxaparin compared to standard dosage prophylaxis. However, 3% of patients on high enoxaparin dosages experienced non-fatal major bleeding.

INTERNAL AND EMERGENCY MEDICINE (2021)

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Review Cardiac & Cardiovascular Systems

SARS-CoV-2 infection and thrombotic complications: a narrative review

Iraklis C. Moschonas et al.

Summary: The global COVID-19 pandemic has caused widespread infections and deaths, with thrombotic complications from infections involving various respiratory viruses having interconnected pathophysiological mechanisms. The incidence of thrombotic events in viral respiratory infections, including SARS-CoV-2, highlights the need for timely antithrombotic therapy and prophylaxis.

JOURNAL OF THROMBOSIS AND THROMBOLYSIS (2021)

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Article Hematology

Heparin in COVID-19 Patients Is Associated with Reduced In-Hospital Mortality: the Multicenter Italian CORIST Study *

Augusto Di Castelnuovo et al.

Summary: This study evaluated the impact of heparin administration on survival in a large cohort of Italian COVID-19 patients and found that in-hospital heparin treatment was associated with a lower mortality rate, especially in severely ill patients and those with strong coagulation activation. Further results from randomized clinical trials are needed to provide clear recommendations.

THROMBOSIS AND HAEMOSTASIS (2021)

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Article Medicine, General & Internal

Early initiation of prophylactic anticoagulation for prevention of coronavirus disease 2019 mortality in patients admitted to hospital in the United States: cohort study

Christopher T. Rentsch et al.

Summary: The study found that early initiation of prophylactic anticoagulation was associated with decreased risk of 30 day mortality among patients hospitalized with covid-19 in the United States, without increasing the risk of serious bleeding events.

BMJ-BRITISH MEDICAL JOURNAL (2021)

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Article Cardiac & Cardiovascular Systems

Anticoagulation Before Hospitalization Is a Potential Protective Factor for COVID-19: Insight From a French Multicenter Cohort Study

Richard Chocron et al.

Summary: The study found that COVID-19 patients receiving anticoagulation therapy before hospitalization had a better prognosis, while those starting anticoagulation therapy during hospitalization were not associated with any outcomes. Early introduction of anticoagulation therapy can help prevent COVID-19-associated coagulopathy and endotheliopathy, leading to a better prognosis for patients.

JOURNAL OF THE AMERICAN HEART ASSOCIATION (2021)

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Article Medicine, General & Internal

Effectiveness of therapeutic heparin versus prophylactic heparin on death, mechanical ventilation, or intensive care unit admission in moderately ill patients with covid-19 admitted to hospital: RAPID randomised clinical trial

Michelle Sholzberg et al.

Summary: This study aimed to evaluate the effects of therapeutic heparin compared with prophylactic heparin among moderately ill patients with covid-19 admitted to hospital wards. The results of the study may help guide the treatment options for similar patients in the future.

BMJ-BRITISH MEDICAL JOURNAL (2021)

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Article Medicine, General & Internal

Efficacy and Safety of Therapeutic-Dose Heparin vs Standard Prophylactic or Intermediate-Dose Heparins for Thromboprophylaxis in High-risk Hospitalized Patients With COVID-19 The HEP-COVID Randomized Clinical Trial

Alex C. Spyropoulos et al.

Summary: Therapeutic-dose low-molecular-weight heparin reduces major thromboembolism and death in high-risk inpatients with COVID-19, with no significant effect observed in critically ill patients.

JAMA INTERNAL MEDICINE (2021)

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Article Medicine, General & Internal

Effect of Intermediate-Dose vs Standard-Dose Prophylactic Anticoagulation on Thrombotic Events, Extracorporeal Membrane Oxygenation Treatment, or Mortality Among Patients With COVID-19 Admitted to the Intensive Care Unit The INSPIRATION Randomized Clinical Trial

Parham Sadeghipour et al.

Summary: This study compared the effect of intermediate-dose and standard prophylactic anticoagulation on a composite outcome among COVID-19 patients admitted to the ICU. The results showed no significant difference between the two groups in terms of thrombotic events, ECMO therapy, or mortality within 30 days. The study does not recommend routine use of intermediate-dose prophylactic anticoagulation in unselected ICU patients with COVID-19.

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION (2021)

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Review Medicine, Research & Experimental

Pharmacological and clinical application of heparin progress: An essential drug for modern medicine

Min Qiu et al.

Summary: Heparin, as the earliest and most widely used anticoagulant and antithrombotic drug, plays a significant role in clinical applications but comes with a range of adverse reactions. Modern research emphasizes the various pharmacological activities and clinical applications of heparin, providing guidance for its development in the medical field.

BIOMEDICINE & PHARMACOTHERAPY (2021)

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Article Medicine, General & Internal

Trends in Venous Thromboembolism Anticoagulation in Patients Hospitalized With COVID-19

Valerie M. Vaughn et al.

Summary: This study analyzed a large, multicenter cohort of patients hospitalized with COVID-19 and found that only a small number of patients had confirmed VTE, with varying use of treatment-dose anticoagulation across hospitals. Nonadherence to VTE prevention and anticoagulation strategies were associated with 60-day mortality, while receiving any dose of anticoagulation (compared to no anticoagulation) was associated with lower in-hospital mortality.

JAMA NETWORK OPEN (2021)

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Review Pathology

COVID-19 Vasculopathy: Mounting Evidence for an Indirect Mechanism of Endothelial Injury

Roberto F. Nicosia et al.

Summary: Critically ill COVID-19 patients develop vascular complications characterized by thrombosis in blood vessels of various sizes. Dysfunction of the vascular endothelium is mainly due to the indirect effects of the virus through cytokine storms and excessive immune response, rather than direct viral entry and infection of endothelial cells.

AMERICAN JOURNAL OF PATHOLOGY (2021)

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Review Hematology

COVID-19-associated coagulopathy and disseminated intravascular coagulation

Hidesaku Asakura et al.

Summary: The pathology of COVID-19 is exacerbated by thrombosis, DIC, and cytokine storms. D-dimer levels are commonly elevated in COVID-19, but relying solely on this marker has limitations. Treatment should be individualized based on disease severity and stage, with potential for combination therapy using heparin and nafamostat in the future. Further research is needed on fibrinolytic therapy and adsorption therapy.

INTERNATIONAL JOURNAL OF HEMATOLOGY (2021)

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Article Medicine, General & Internal

A Novel Coronavirus from Patients with Pneumonia in China, 2019

Na Zhu et al.

NEW ENGLAND JOURNAL OF MEDICINE (2020)

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Article Hematology

Impact of anticoagulation prior to COVID-19 infection: a propensity score-matched cohort study

Douglas Tremblay et al.

BLOOD (2020)

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Article Hematology

COVID-19 and its implications for thrombosis and anticoagulation

Jean M. Connors et al.

BLOOD (2020)

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Article Cardiac & Cardiovascular Systems

Deep Vein Thrombosis in Hospitalized Patients With COVID-19 in Wuhan, China Prevalence, Risk Factors, and Outcome

Li Zhang et al.

CIRCULATION (2020)

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Article Hematology

Incidence of venous thromboembolism in hospitalized patients with COVID-19

Saskia Middeldorp et al.

JOURNAL OF THROMBOSIS AND HAEMOSTASIS (2020)

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Article Hematology

Prevalence of venous thromboembolism in patients with severe novel coronavirus pneumonia

Songping Cui et al.

JOURNAL OF THROMBOSIS AND HAEMOSTASIS (2020)

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Article Hematology

Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy

Ning Tang et al.

JOURNAL OF THROMBOSIS AND HAEMOSTASIS (2020)

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Article Cardiac & Cardiovascular Systems

COVID-19 update: Covid-19-associated coagulopathy

Richard C. Becker

JOURNAL OF THROMBOSIS AND THROMBOLYSIS (2020)

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Review Biochemistry & Molecular Biology

An overview of COVID-19

Yu Shi et al.

JOURNAL OF ZHEJIANG UNIVERSITY-SCIENCE B (2020)

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Article Medicine, General & Internal

Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China

Chaomin Wu et al.

JAMA INTERNAL MEDICINE (2020)

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Article Medicine, General & Internal

Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

Fei Zhou et al.

LANCET (2020)

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Article Critical Care Medicine

Pulmonary and cardiac pathology in African American patients with COVID-19: an autopsy series from New Orleans

Sharon E. Fox et al.

LANCET RESPIRATORY MEDICINE (2020)

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Article Medicine, General & Internal

Pulmonary Vascular Endothelialitis, Thrombosis, and Angiogenesis in Covid-19

Maximilian Ackermann et al.

NEW ENGLAND JOURNAL OF MEDICINE (2020)

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Article Pharmacology & Pharmacy

Clinical impact of pre-admission antithrombotic therapy in hospitalized patients with COVID-19: A multicenter observational study

Vincenzo Russo et al.

PHARMACOLOGICAL RESEARCH (2020)

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Article Biochemistry & Molecular Biology

SARS-CoV-2 Infection Depends on Cellular Heparan Sulfate and ACE2

Thomas Mandel Clausen et al.

CELL (2020)

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Article Medicine, Research & Experimental

The Potential of Low Molecular Weight Heparin to Mitigate Cytokine Storm in Severe COVID-19 Patients: A Retrospective Cohort Study

Chen Shi et al.

CTS-CLINICAL AND TRANSLATIONAL SCIENCE (2020)

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Article Hematology

Incidence of thrombotic complications in critically ill ICU patients with COVID-19

F. A. Klok et al.

THROMBOSIS RESEARCH (2020)

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Article Hematology

Heparin Inhibits Cellular Invasion by SARS-CoV-2: Structural Dependence of the Interaction of the Spike S1 Receptor-Binding Domain with Heparin

Courtney J. Mycroft-West et al.

THROMBOSIS AND HAEMOSTASIS (2020)

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Article Hematology

Anticoagulation and bleeding risk in patients with COVID-19

Nancy Musoke et al.

THROMBOSIS RESEARCH (2020)

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Article Hematology

Therapeutic versus prophylactic anticoagulation for severe COVID-19: A randomized phase II clinical trial (HESACOVID)

Anna Cristina Bertoldi Lemos et al.

THROMBOSIS RESEARCH (2020)

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Article Medicine, General & Internal

Thromboprophylaxis with enoxaparin is associated with a lower death rate in patients hospitalized with SARS-CoV-2 infection. A cohort study

Filippo Albani et al.

ECLINICALMEDICINE (2020)

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Review Immunology

How COVID-19 induces cytokine storm with high mortality

Shintaro Hojyo et al.

INFLAMMATION AND REGENERATION (2020)

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Article Biochemistry & Molecular Biology

Heparin and anticoagulation

Akihiro Onishi et al.

FRONTIERS IN BIOSCIENCE-LANDMARK (2016)

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Article Cardiac & Cardiovascular Systems

Pharmacology of anticoagulants used in the treatment of venous thromboembolism

Edith A. Nutescu et al.

JOURNAL OF THROMBOSIS AND THROMBOLYSIS (2016)

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Review Pharmacology & Pharmacy

Pharmacology of Heparin and Related Drugs

Barbara Mulloy et al.

PHARMACOLOGICAL REVIEWS (2016)

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Letter Critical Care Medicine

Low-dose heparin during extracorporeal membrane oxygenation treatment in adults

Hye Ju Yeo et al.

INTENSIVE CARE MEDICINE (2015)

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Article Hematology

Is the Incidence Trend of Heparin-Induced Thrombocytopenia Decreased by the Increased Use of Low-Molecular-Weight-Heparin?

Fahad A. S. Al-Eidan

MEDITERRANEAN JOURNAL OF HEMATOLOGY AND INFECTIOUS DISEASES (2015)

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Review Pharmacology & Pharmacy

Recent advances in antithrombotic treatment for acute coronary syndromes

James P. Howard et al.

EXPERT REVIEW OF CLINICAL PHARMACOLOGY (2014)

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Article Critical Care Medicine

Parenteral Anticoagulants Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines

David A. Garcia et al.

CHEST (2012)

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Article Critical Care Medicine

Evidence-Based Management of Anticoagulant Therapy Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines

Anne Holbrook et al.

CHEST (2012)

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Article Pharmacology & Pharmacy

Effect of heparin and low-molecular weight heparin on serum potassium and sodium levels

Girish M. Bengalorkar et al.

JOURNAL OF PHARMACOLOGY & PHARMACOTHERAPEUTICS (2011)

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Article Hematology

Bleeding risk and the management of bleeding complications in patients undergoing anticoagulant therapy: focus on new anticoagulant agents

Mark A. Crowther et al.

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Review Pharmacology & Pharmacy

Pharmacodynamic and pharmacokinetic properties of enoxaparin - Implications for clinical practice

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Low molecular weight heparin in COVID-19: benefits and concerns

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