Cardillo Giuseppe, Viggiano Giuseppe Vito, Russo Vincenzo, Mangiacapra Sara, Cavalli Antonella, Castaldo Giampiero, Agrusta Federica, Bellizzi Annamaria, Amitrano Maria, Iannuzzo Mariateresa, Sacco Clara, Lodigiani Corrado, Fontanella Andrea, Di Micco Pierpaolo
Medylab, Biochimica Avanzata Laboratory, Naples, Italy.
UO Pronto Soccorso e Medicina D'urgenza, Semintensiva Covid, Ospedale Ramazzini Di Carpi - AUSL Modena, Modena, Italy.
J Blood Med. 2021 Feb 11;12:69-75. doi: 10.2147/JBM.S285214. eCollection 2021.
Since the outbreak of novel coronavirus SARS-CoV2 around the world, great attention has been paid to the effects of such antithrombotic drugs as heparinoids, because they have antiviral action in vitro and antithrombotic actions in vivo. We conducted a retrospective analysis in inpatients with confirmed COVID-19 on the anti-inflammatory and antithrombotic effects of enoxaparin and fondaparinux at prophylactic doses.
This retrospective cohort study used patients with confirmed COVID-19 during the first months of the Italian outbreak from February 18 to April 30, 2020. Our aim was to compare clinical characteristics, prophylactic treatment, markers of inflammation, and thrombotic outcomes in inpatients positive for SARS-CoV2 during hospitalization associated with thromboprophylaxis with enoxaparin (40 mg or 60 mg once daily) or fondaparinux (2.5 mg once daily). Statistical analysis was conducted with using MatLab R2016B and ad hoc functions.
There were no significatant differences in clinical characteristics between patients that used enoxaparin or fondaparinux as thromboprophylaxis for SARS-CoV2. No differences were found in D-dimer and fibrinogen levels either, which were used as markers of inflammation during the infection at testing on admission and after 3 weeks.Significant differences in CRP, IL6, and LDH were found in patients after 21 days' treatment.
Increased levels of fibrinogen and D-dimer in patients with confirmed COVID-19 have been reported in several studies. Our results showed that anti-inflammatory effects of fondaparinux and enoxaparin after 3 weeks of prophylactic treatment were similar when levels of fibrinogen and D-dimer were considered. Furthermore, levels of CRP showed a decrease in patients treated with enoxaparin and fondaparinux, although the decrease in the fondaparinux group seems to be more relevant.
自新型冠状病毒SARS-CoV-2在全球爆发以来，类肝素等抗血栓药物的作用受到了极大关注，因为它们在体外具有抗病毒作用，在体内具有抗血栓作用。我们对确诊的COVID-19住院患者进行了回顾性分析，以研究预防剂量的依诺肝素和磺达肝癸钠的抗炎和抗血栓作用。
这项回顾性队列研究使用了2020年2月18日至4月30日意大利疫情爆发头几个月确诊的COVID-19患者。我们的目的是比较SARS-CoV-2阳性住院患者在接受依诺肝素（40毫克或60毫克每日一次）或磺达肝癸钠（2.5毫克每日一次）血栓预防期间的临床特征、预防性治疗、炎症标志物和血栓形成结果。使用MatLab R2016B和专门函数进行统计分析。
使用依诺肝素或磺达肝癸钠作为SARS-CoV-2血栓预防的患者在临床特征上没有显著差异。在入院检测时和3周后作为感染期间炎症标志物的D-二聚体和纤维蛋白原水平也没有差异。治疗21天后患者的CRP、IL-6和LDH有显著差异。
多项研究报告了确诊的COVID-19患者纤维蛋白原和D-二聚体水平升高。我们的结果表明，在考虑纤维蛋白原和D-二聚体水平时，预防性治疗3周后磺达肝癸钠和依诺肝素的抗炎作用相似。此外，依诺肝素和磺达肝癸钠治疗的患者CRP水平有所下降，尽管磺达肝癸钠组的下降似乎更明显。
