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低分子量肝素减轻重症 COVID-19 患者细胞因子风暴的潜力:一项回顾性队列研究。

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

机构信息

Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Hubei Province Clinical Research Center for Precision Medicine for Critical Illness, Wuhan, China.

出版信息

Clin Transl Sci. 2020 Nov;13(6):1087-1095. doi: 10.1111/cts.12880. Epub 2020 Oct 15.

Abstract

On March 11, 2020, the World Health Organization declared its assessment of coronavirus disease 2019 (COVID-19) as a global pandemic. However, specific anti-severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) drugs are still under development, and patients are managed by multiple complementary treatments. We performed a retrospective analysis to compare and evaluate the effect of low molecular weight heparin (LMWH) treatment on disease progression. For this purpose, the clinical records and laboratory indicators were extracted from electronic medical records of 42 patients with COVID-19 (21 of whom were treated with LMWH, and 21 without LMWH) hospitalized (Union Hospital of Huazhong University of Science and Technology) from February 1 to March 15, 2020. Changes in the percentage of lymphocytes before and after LMWH treatment were significantly different from those in the control group (P = 0.011). Likewise, changes in the levels of D-dimer and fibrinogen degradation products in the LMWH group before and after treatment were significantly different from those in the control group (P = 0.035). Remarkably, IL-6 levels were significantly reduced after LMWH treatment (P = 0.006), indicating that, besides other beneficial properties, LMWH may exert an anti-inflammatory effect and attenuate in part the "cytokine storm" induced by the virus. Our results support the use of LMWH as a potential therapeutic drug for the treatment of COVID-19, paving the way for a subsequent well-controlled clinical study.

摘要

2020 年 3 月 11 日,世界卫生组织宣布将 2019 年冠状病毒病(COVID-19)评估为全球大流行。然而,针对严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)的特效药物仍在研发中,患者需要接受多种互补治疗。我们进行了一项回顾性分析,以比较和评估低分子肝素(LMWH)治疗对疾病进展的影响。为此,我们从 2020 年 2 月 1 日至 3 月 15 日期间在华中科技大学同济医学院附属协和医院住院的 42 例 COVID-19 患者(其中 21 例接受 LMWH 治疗,21 例未接受 LMWH 治疗)的电子病历中提取了临床记录和实验室指标。LMWH 治疗前后淋巴细胞百分比的变化与对照组相比差异有统计学意义(P=0.011)。同样,LMWH 治疗前后 D-二聚体和纤维蛋白原降解产物水平的变化与对照组相比差异有统计学意义(P=0.035)。值得注意的是,LMWH 治疗后白细胞介素 6(IL-6)水平显著降低(P=0.006),表明除了其他有益特性外,LMWH 可能具有抗炎作用,并在一定程度上减轻病毒引起的“细胞因子风暴”。我们的结果支持将 LMWH 用作 COVID-19 治疗的潜在治疗药物,为随后进行的良好对照临床研究铺平了道路。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/254d/7719364/b53d13d09157/CTS-13-1087-g001.jpg

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