Aggressive thromboprophylaxis improves clinical process and decreases the need of Intensive Care Unit in Covid-19

  • Murat Ugur Health Sciences University, Sancaktepe Sehit Professor Doctor Ilhan Varank Education and Research Hospital, Department of Cardiovascular Surgery, Istanbul, Turkey
  • Esra Adiyeke Health Sciences University, Sancaktepe Sehit Professor Doctor Ilhan Varank Education and Research Hospital, Department of Anesthesiology and Reanimation, Istanbul, Turkey
  • Eymen Recep Health Sciences University, Sancaktepe Sehit Professor Doctor Ilhan Varank Education and Research Hospital, Department of Cardiovascular Surgery, Istanbul, Turkey
  • Nurten Bakan Health Sciences University, Sancaktepe Sehit Professor Doctor Ilhan Varank Education and Research Hospital, Department of Anesthesiology and Reanimation, Istanbul, Turkey
  • Nurettin Yiyit Health Sciences University, Sancaktepe Sehit Professor Doctor Ilhan Varank Education and Research Hospital, Department of Thoracic Surgery, Istanbul, Turkey
Keywords: COVID-19, Low molecular weight heparin, Thrombosis

Abstract

Background and Objectives: COVID-19 might cause thrombosis in the arterial and venous system either directly or via indirect means such as cytokine storm or hypoxia. Enoxaparin might contribute to clinical recovery in COVID-19 patients, both by reducing the risk of thrombosis with anticoagulant effect and avoiding the cytokine storm with its anti-inflammatory effect. In this study, the clinical results of prophylactic enoxaparin usage in COVID-19 patients in our hospital were investigated.

Methods: We retrospectively analyzed the patients who had hospitalized in our hospital with the diagnosis of COVID-19 between March 12 and April 17, 2020. Patients were divided into two groups according to their clinical status. Patients who were discharged to their home were in Group-I and were transferred to intensive care unit (ICU) were in Group-II. Patients’ demographics and laboratory examinations were compared between the groups. Then the effect of LMWH treatment in the rate of ICU transfer was evaluated.

Results: There were 1216 hospitalized patients with COVID-19 in the study period. Increased age, levels of D-Dimer and fibrinogen and decreased hemoglobin, platelet, lymphocyte values were found to be statistically significantly risk factor for the need of ICU. Transfer rates of ICU were two times more in the patients who did not used enoxaparin and readmission after the discharge was higher in the patients who did not received enoxaparin in the hospital.

Conclusion: Enoxaparin treatment in COVID-19 might be effective not only anticoagulant effect but also anti-inflammatory effect that decreased the risk cytokine storm. In the patients with COVID-19 disease, starting enoxaparin treatment in the earlier stage will decrease the risk of microthrombosis in vital organs and might improve the clinical outcomes.

doi: https://doi.org/10.12669/pjms.37.3.3687

How to cite this:
Ugur M, Adiyeke E, Recep E, Bakan N, Yiyit N. Aggressive thromboprophylaxis improves clinical process and decreases the need of Intensive Care Unit in Covid-19. Pak J Med Sci. 2021;37(3):668-674. doi: https://doi.org/10.12669/pjms.37.3.3687

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Published
2021-03-26
How to Cite
Ugur, M., Adiyeke, E., Recep, E., Bakan, N., & Yiyit, N. (2021). Aggressive thromboprophylaxis improves clinical process and decreases the need of Intensive Care Unit in Covid-19. Pakistan Journal of Medical Sciences, 37(3). https://doi.org/10.12669/pjms.37.3.3687
Section
Original Articles