Makarem Adham, Zareef Rana, Abourjeili Joseph, Nassar Joseph E, Bitar Fadi, Arabi Mariam
Department of Health Law, Policy & Management, School of Public Health, Boston University, Boston, MA, United States.
Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Front Pharmacol. 2023 Apr 27;14:1159363. doi: 10.3389/fphar.2023.1159363. eCollection 2023.
Since its emergence, the COVID-19 pandemic had a dramatic impact on the public health worldwide and it scarred the medical, economical, and social determinants of health. Even after the significant vaccination advances, the disease of SARS-CoV-2 can manifest in severe presentations with life-threatening thromboembolic and multi-organ complications leading to notable morbidity and mortality. Clinicians and researchers are on continuous pursuit of investigating different approaches in the attempt to prevent the infection and minimize its severity. Although the COVID-19's pathophysiology remains relatively unclear, it is well established now that coagulopathy, systemic thrombotic propensity, and a robust immunoinflammatory response are some of the most important determinants of its morbidity and mortality. Accordingly, research efforts have focused on addressing the inflammatory and hematological cascades using available agents to avoid thromboembolic events. Several studies and investigators have emphasized the importance of Low molecular weight heparin (LMWH), namely, Lovenox, in addressing these sequelae of the COVID-19 disease, either prophylactically or therapeutically. This review explores the benefits and concerns of employing LMWH, a widely used anticoagulant, in COVID-19 disease. It delves into Enoxaparin as a molecule, along with its pharmacology, mechanism of action, and clinical uses. It also reviews the current high-quality clinical evidence that highlight the role of enoxaparin in SARS-CoV-2 infection.
自出现以来,新冠疫情对全球公共卫生产生了巨大影响,它给健康的医学、经济和社会决定因素都留下了创伤。即使在疫苗接种取得重大进展之后,新冠病毒疾病仍可能以严重的形式出现,伴有危及生命的血栓栓塞和多器官并发症,导致明显的发病率和死亡率。临床医生和研究人员一直在不断探索不同的方法,试图预防感染并将其严重程度降至最低。尽管新冠病毒的病理生理学仍相对不清楚,但目前已经明确,凝血病、全身血栓形成倾向和强烈的免疫炎症反应是其发病率和死亡率的一些最重要决定因素。因此,研究工作集中在使用现有药物来应对炎症和血液学级联反应,以避免血栓栓塞事件。一些研究和研究人员强调了低分子量肝素(LMWH),即速碧林,在预防或治疗新冠病毒疾病这些后遗症方面的重要性。这篇综述探讨了在新冠病毒疾病中使用广泛应用的抗凝剂低分子量肝素的益处和问题。它深入研究了依诺肝素这个分子,以及它的药理学、作用机制和临床用途。它还回顾了目前突出依诺肝素在新冠病毒感染中作用的高质量临床证据。