Comparison of the Effect of Unfractionated Heparin and Enoxaparin Sodium at Different Doses on the Course of COVID-19-Associated Coagulopathy
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 unf...
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MDPI AG
2021-09-01
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| Online Access: | https://www.mdpi.com/2075-1729/11/10/1032 |
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| author | Oleksandr Oliynyk Wojciech Barg Anna Slifirczyk Yanina Oliynyk Serhij Dubrov Vitaliy Gurianov Marta Rorat |
| author_facet | Oleksandr Oliynyk Wojciech Barg Anna Slifirczyk Yanina Oliynyk Serhij Dubrov Vitaliy Gurianov Marta Rorat |
| author_sort | Oleksandr Oliynyk |
| collection | DOAJ |
| description | 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 (<i>p</i> = 0.026, odds ratio (OR) = 3.33, 95% confidence interval (CI) 1.15–9.59), and an increased risk of death (<i>p</i> = 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. |
| first_indexed | 2024-03-10T06:27:24Z |
| format | Article |
| id | doaj.art-e54b4280583b4337915b6bf442a0d9e7 |
| institution | Directory Open Access Journal |
| issn | 2075-1729 |
| language | English |
| last_indexed | 2024-03-10T06:27:24Z |
| publishDate | 2021-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Life |
| spelling | doaj.art-e54b4280583b4337915b6bf442a0d9e72023-11-22T18:52:27ZengMDPI AGLife2075-17292021-09-011110103210.3390/life11101032Comparison of the Effect of Unfractionated Heparin and Enoxaparin Sodium at Different Doses on the Course of COVID-19-Associated CoagulopathyOleksandr Oliynyk0Wojciech Barg1Anna Slifirczyk2Yanina Oliynyk3Serhij Dubrov4Vitaliy Gurianov5Marta Rorat6Department of Anaesthesiology and Intensive Care, Bogomolets National Medical University, 01601 Kyiv, UkraineDepartment of Internal Medicine, Pneumonology and Allergology, Wroclaw Medical University, 50-367 Wroclaw, PolandDepartment of Emergency Medicine, Pope John II State School of Higher Education in Biala Podlaska, 21-500 Biala Podlaska, PolandDepartment of Immunology and Allergology, Bogomolets National Medical University, 01601 Kyiv, UkraineDepartment of Anaesthesiology and Intensive Care, Bogomolets National Medical University, 01601 Kyiv, UkraineDepartment of Medical Statistics, Bogomolets National Medical University, 01601 Kyiv, UkraineDepartment of Forensic Medicine, Wroclaw Medical University, 50-367 Wroclaw, PolandBackground: 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 (<i>p</i> = 0.026, odds ratio (OR) = 3.33, 95% confidence interval (CI) 1.15–9.59), and an increased risk of death (<i>p</i> = 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.https://www.mdpi.com/2075-1729/11/10/1032anticoagulant therapyblood coagulationSARS-CoV-2respiratory failure |
| spellingShingle | Oleksandr Oliynyk Wojciech Barg Anna Slifirczyk Yanina Oliynyk Serhij Dubrov Vitaliy Gurianov Marta Rorat Comparison of the Effect of Unfractionated Heparin and Enoxaparin Sodium at Different Doses on the Course of COVID-19-Associated Coagulopathy Life anticoagulant therapy blood coagulation SARS-CoV-2 respiratory failure |
| title | Comparison of the Effect of Unfractionated Heparin and Enoxaparin Sodium at Different Doses on the Course of COVID-19-Associated Coagulopathy |
| title_full | Comparison of the Effect of Unfractionated Heparin and Enoxaparin Sodium at Different Doses on the Course of COVID-19-Associated Coagulopathy |
| title_fullStr | Comparison of the Effect of Unfractionated Heparin and Enoxaparin Sodium at Different Doses on the Course of COVID-19-Associated Coagulopathy |
| title_full_unstemmed | Comparison of the Effect of Unfractionated Heparin and Enoxaparin Sodium at Different Doses on the Course of COVID-19-Associated Coagulopathy |
| title_short | Comparison of the Effect of Unfractionated Heparin and Enoxaparin Sodium at Different Doses on the Course of COVID-19-Associated Coagulopathy |
| title_sort | comparison of the effect of unfractionated heparin and enoxaparin sodium at different doses on the course of covid 19 associated coagulopathy |
| topic | anticoagulant therapy blood coagulation SARS-CoV-2 respiratory failure |
| url | https://www.mdpi.com/2075-1729/11/10/1032 |
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