Bemiparin Versus Enoxaparin for Extended Thromboprophylaxis in COVID-19 Patients at High Risk of Venous Thromboembolism
Introduction: Patients with COVID-19 are at increased risk of thromboembolic events during hospitalization and after discharge. Current guidelines recommend use of extended thromboprophylaxis in hospitalized COVID-19 patients who have high risk of post-discharge venous thromboembolism and low risk o...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | Turkish |
| Published: |
Galenos Yayinevi
2021-01-01
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| Series: | Mediterranean Journal of Infection, Microbes and Antimicrobials |
| Subjects: | |
| Online Access: | http://mjima.org/abstract.php?id=294 |
| _version_ | 1797906406258507776 |
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| author | Ahmet Can TOPÇU Gözde ÖZTÜRK-ALTUNYURT Nurdan PAPILA-TOPAL Ayşe BATIREL |
| author_facet | Ahmet Can TOPÇU Gözde ÖZTÜRK-ALTUNYURT Nurdan PAPILA-TOPAL Ayşe BATIREL |
| author_sort | Ahmet Can TOPÇU |
| collection | DOAJ |
| description | Introduction: Patients with COVID-19 are at increased risk of thromboembolic events during hospitalization and after discharge. Current guidelines recommend use of extended thromboprophylaxis in hospitalized COVID-19 patients who have high risk of post-discharge venous thromboembolism and low risk of bleeding. We aimed to report our experience regarding different low-molecular-weight heparins administered post-discharge in a COVID-19 patient population with high-thromboembolic and low-bleeding risk.
Methods: This was a single-center, retrospective, observational study. Consecutive patients admitted with a confirmed diagnosis of COVID-19 between March 16 and July 16, 2020, were assessed for enrollment. Patients were included if they received prophylaxis with low-molecular-weight heparins after discharge, were ≥18 years of age, and completed follow-up. Pregnant women, children <18 years of age, patients with intensive care unit admission, and patients who experienced venous and/or arterial thromboembolism prior to discharge were excluded. Extended thromboprophylaxis with either enoxaparin 4000 IU once daily or bemiparin 3500 IU once daily was prescribed if a patient had a modified IMPROVE VTE score of ≥4, or a modified IMPROVE score of ≥2 and a D-dimer level of ≥2 times the reference range. Patients were followed-up for 30 days after discharge. Primary endpoint was occurrence of radiologically confirmed symptomatic venous thromboembolism (deep vein thrombosis and/or pulmonary embolism).
Results: A total of 3498 consecutive patients were hospitalized with a diagnosis of COVID-19. Of them, 38 (20 women) received extended thromboprophylaxis. Mean of age was 66.6±15.7 years. Twenty-five patients received enoxaparin, and 13 received bemiparin. Three patients in the enoxaparin group and none of the patients in the bemiparin group experienced post-discharge venous thromboembolism (p=0.681). Major bleeding occurred in one patient in the enoxaparin group, and in zero patients in the bemiparin group (p=0.456).
Conclusion: Enoxaparin and bemiparin have similar prophylactic properties when used for prevention of post-discharge venous thromboembolism in COVID-19 survivors who have high thromboembolic and low bleeding risk. |
| first_indexed | 2024-04-10T10:20:28Z |
| format | Article |
| id | doaj.art-c66655ea4bcb44059b24c15745ff4ef9 |
| institution | Directory Open Access Journal |
| issn | 2147-673X |
| language | Turkish |
| last_indexed | 2024-04-10T10:20:28Z |
| publishDate | 2021-01-01 |
| publisher | Galenos Yayinevi |
| record_format | Article |
| series | Mediterranean Journal of Infection, Microbes and Antimicrobials |
| spelling | doaj.art-c66655ea4bcb44059b24c15745ff4ef92023-02-15T16:21:39ZturGalenos YayineviMediterranean Journal of Infection, Microbes and Antimicrobials2147-673X2021-01-0110110.4274/mjima.galenos.2021.2021.65Bemiparin Versus Enoxaparin for Extended Thromboprophylaxis in COVID-19 Patients at High Risk of Venous ThromboembolismAhmet Can TOPÇU0https://orcid.org/0000-0002-7335-4788Gözde ÖZTÜRK-ALTUNYURT1https://orcid.org/0000-0002-0021-8566Nurdan PAPILA-TOPAL2https://orcid.org/0000-0001-9745-6845Ayşe BATIREL3https://orcid.org/0000-0002-6005-636XUniversity of Health Sciences Turkey, Kartal Dr. Lütfi Kırdar City Hospital, Clinic of Cardiovascular Surgery, İstanbul, TurkeyUniversity of Health Sciences Turkey, Kartal Dr. Lütfi Kırdar City Hospital, Clinic of Infectious Diseases and Clinical Microbiology, İstanbul, TurkeyUniversity of Health Sciences Turkey, Kartal Dr. Lütfi Kırdar City Hospital, Clinic of Cardiology, İstanbul, TurkeyUniversity of Health Sciences Turkey, Kartal Dr. Lütfi Kırdar City Hospital, Clinic of Infectious Diseases and Clinical Microbiology, İstanbul, TurkeyIntroduction: Patients with COVID-19 are at increased risk of thromboembolic events during hospitalization and after discharge. Current guidelines recommend use of extended thromboprophylaxis in hospitalized COVID-19 patients who have high risk of post-discharge venous thromboembolism and low risk of bleeding. We aimed to report our experience regarding different low-molecular-weight heparins administered post-discharge in a COVID-19 patient population with high-thromboembolic and low-bleeding risk. Methods: This was a single-center, retrospective, observational study. Consecutive patients admitted with a confirmed diagnosis of COVID-19 between March 16 and July 16, 2020, were assessed for enrollment. Patients were included if they received prophylaxis with low-molecular-weight heparins after discharge, were ≥18 years of age, and completed follow-up. Pregnant women, children <18 years of age, patients with intensive care unit admission, and patients who experienced venous and/or arterial thromboembolism prior to discharge were excluded. Extended thromboprophylaxis with either enoxaparin 4000 IU once daily or bemiparin 3500 IU once daily was prescribed if a patient had a modified IMPROVE VTE score of ≥4, or a modified IMPROVE score of ≥2 and a D-dimer level of ≥2 times the reference range. Patients were followed-up for 30 days after discharge. Primary endpoint was occurrence of radiologically confirmed symptomatic venous thromboembolism (deep vein thrombosis and/or pulmonary embolism). Results: A total of 3498 consecutive patients were hospitalized with a diagnosis of COVID-19. Of them, 38 (20 women) received extended thromboprophylaxis. Mean of age was 66.6±15.7 years. Twenty-five patients received enoxaparin, and 13 received bemiparin. Three patients in the enoxaparin group and none of the patients in the bemiparin group experienced post-discharge venous thromboembolism (p=0.681). Major bleeding occurred in one patient in the enoxaparin group, and in zero patients in the bemiparin group (p=0.456). Conclusion: Enoxaparin and bemiparin have similar prophylactic properties when used for prevention of post-discharge venous thromboembolism in COVID-19 survivors who have high thromboembolic and low bleeding risk.http://mjima.org/abstract.php?id=294bemiparincovid-19enoxaparinextended thromboprophylaxislow-molecular-weight heparin |
| spellingShingle | Ahmet Can TOPÇU Gözde ÖZTÜRK-ALTUNYURT Nurdan PAPILA-TOPAL Ayşe BATIREL Bemiparin Versus Enoxaparin for Extended Thromboprophylaxis in COVID-19 Patients at High Risk of Venous Thromboembolism Mediterranean Journal of Infection, Microbes and Antimicrobials bemiparin covid-19 enoxaparin extended thromboprophylaxis low-molecular-weight heparin |
| title | Bemiparin Versus Enoxaparin for Extended Thromboprophylaxis in COVID-19 Patients at High Risk of Venous Thromboembolism |
| title_full | Bemiparin Versus Enoxaparin for Extended Thromboprophylaxis in COVID-19 Patients at High Risk of Venous Thromboembolism |
| title_fullStr | Bemiparin Versus Enoxaparin for Extended Thromboprophylaxis in COVID-19 Patients at High Risk of Venous Thromboembolism |
| title_full_unstemmed | Bemiparin Versus Enoxaparin for Extended Thromboprophylaxis in COVID-19 Patients at High Risk of Venous Thromboembolism |
| title_short | Bemiparin Versus Enoxaparin for Extended Thromboprophylaxis in COVID-19 Patients at High Risk of Venous Thromboembolism |
| title_sort | bemiparin versus enoxaparin for extended thromboprophylaxis in covid 19 patients at high risk of venous thromboembolism |
| topic | bemiparin covid-19 enoxaparin extended thromboprophylaxis low-molecular-weight heparin |
| url | http://mjima.org/abstract.php?id=294 |
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