Heparin for patients with coronavirus disease 2019 and hypercoagulation complications: A cohort study

Muhammad Fachri; Mochammad Hatta; Sefia Nabila Nur Azmi Tarigan; Risky Akaputra; Ressy Dwiyanti; Ahmad Syukri; Ade Rifka Junita; Muhammad Reza Primaguna; Andini Febrianty

doi:10.1016/j.amsu.2022.104042

Heparin for patients with coronavirus disease 2019 and hypercoagulation complications: A cohort study

Ann Med Surg (Lond). 2022 Jul:79:104042. doi: 10.1016/j.amsu.2022.104042. Epub 2022 Jun 28.

Authors

Affiliations

¹ Department of Pulmonology and Respiratory Medicine, Faculty of Medicine and Health, Universitas Muhammadiyah Jakarta, Jakarta, Indonesia.
² Molecular Biology and Immunology Laboratory, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.
³ Department of Forensic and Medicolegal, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.
⁴ Department of Medical Microbiology, Faculty of Medicine, Tadulako University, Palu, Indonesia.
⁵ Postgraduate School, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.
⁶ Department of Internal Medicine, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.

Abstract

Background: Thrombotic complications of coronavirus disease 2019 (COVID-19) are a worrisome aspect of the disease due to their high incidence in critically ill patients and their poor clinical outcomes. The aim of this study was to compare the effectiveness of unfractionated heparin (UFH) and low molecular weight heparin (LMWH) (fondaparinux) in hospitalized COVID-19 patients with hypercoagulable complications.

Material and methods: The study design used a retrospective cohort approach incorporating pre- and post-tests via secondary data extracted from the medical records of inpatients with confirmed COVID-19.

Results: Among the 98 individuals studied (52% women; 30.6% at >60 years of age), 35 patients received UFH, while the remaining 63 patients received LMWH (fondaparinux). The greatest decrease in the D-dimer value (0.01 ± 0.5 g fibrinogen equivalent units/mL) was observed in 12 (34.3%) and 15 (23.8%) patients in the UFH and LMWH (fondaparinux) groups, respectively. Most inpatients with confirmed COVID-19 were aged 50-59 years and were women.

Conclusion: There was a tendency toward increased D-dimer, normal prothrombin time, normal activated partial thromboplastin clotting time, and increased fibrinogen values in each COVID-19 patient. The results demonstrated a significant relationship between the D-dimer and prothrombin time parameter in confirmed COVID-19 inpatients.

Keywords: COVID-19; D-dimer; Heparin; Hypercoagulation; LMWH (Fondaparinux).