Canoglu Kadir, Saylan Bengu
From the Department of Pulmonology, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey.
Ann Saudi Med. 2020 Nov-Dec;40(6):462-468. doi: 10.5144/0256-4947.2020.462. Epub 2020 Dec 3.
Venous thromboembolism or extensive thrombosis is relatively common in patients with severe COVID-19 infection and has been associated with increased mortality. During the current COVID-19 pandemic, several prophylactic doses and types of low-molecular-weight heparin (LMWH) are being used worldwide; however, there are no high-quality studies or recommendations for an optimal prophylactic LMWH dose.
Investigate the relationship between coagulation parameters and the LMWH dose, and mortality and ICU admission in hospitalized patients with severe COVID-19 pneumonia.
Retrospective.
Tertiary care hospital.
Data on clinical features, coagulation parameters and anticoagulant medications of inpatients with severe COVID-19 were collected for the period between 11 March 2020 and 31 April 2020.
Mortality and ICU admission for prophylactic dose LMWH (0.5 mg/kg twice daily) and therapeutic dose LMWH (1 mg/kg twice daily).
154 cases.
Ninety-eight (63.6%) patients were treated with the LMWH prophylactic dose and 56 (36.4%) patients were treated with the therapeutic dose. Forty-four (44.9%) of 98 patients using the prophylactic dose LMWH died, while 10 (17.9%) of 56 patients using the therapeutic dose LMWH died (=.001). Mortality was 6.4-fold higher in the prophylactic dose LMWH users than in the therapeutic dose LMWH users (OR=6.5, 95% CI: 2.4-17.6, <.001).
Therapeutic dosing of LMWH may decrease mortality in patients with severe COVID-19 infected pneumonia. More aggressive thromboprophylaxis regimens using higher doses of heparin should be evaluated in prospective studies.
Lack of information about bleeding complications. LMWH was not compared with other anticoagulant therapies. There was no comparison between our two groups on the APACHE score. Used different doses of LMWH in different clinics in our hospital. Single-center, retrospective study.
None.
静脉血栓栓塞或广泛血栓形成在重症新型冠状病毒肺炎（COVID-19）感染患者中相对常见，且与死亡率增加相关。在当前的COVID-19大流行期间，全球正在使用几种预防剂量和类型的低分子肝素（LMWH）；然而，尚无关于最佳预防LMWH剂量的高质量研究或建议。
研究重症COVID-19肺炎住院患者凝血参数与LMWH剂量之间的关系，以及死亡率和入住重症监护病房（ICU）情况。
回顾性研究。
三级医疗中心医院。
收集2020年3月11日至2020年4月31日期间重症COVID-19住院患者的临床特征、凝血参数和抗凝药物数据。
预防剂量LMWH（0.5mg/kg，每日两次）和治疗剂量LMWH（1mg/kg，每日两次）的死亡率和入住ICU情况。
154例。
98例（63.6%）患者接受LMWH预防剂量治疗，56例（36.4%）患者接受治疗剂量治疗。使用预防剂量LMWH的98例患者中有44例（44.9%）死亡，而使用治疗剂量LMWH的56例患者中有10例（17.9%）死亡（P=0.001）。预防剂量LMWH使用者的死亡率比治疗剂量LMWH使用者高6.4倍（比值比=6.5，95%置信区间：2.4-17.6，P<0.001）。
LMWH治疗剂量可能降低重症COVID-19感染肺炎患者的死亡率。应在前瞻性研究中评估使用更高剂量肝素的更积极的血栓预防方案。
缺乏出血并发症信息。未将LMWH与其他抗凝治疗进行比较。两组之间未比较急性生理学与慢性健康状况评分系统（APACHE）评分。我院不同科室使用不同剂量的LMWH。单中心回顾性研究。
无。
