Effects of Differences in Doses of Low-Molecular Weight Heparin in Severe COVID-19 Patients.

Objective: The most prominent clinical finding in severe COVID-19 patients is endothelial damage. For these reasons, active administration of anticoagulants (such as heparin) is recommended to patients with severe COVID-19. The purpose of this study is to investigate the effects of different doses of low-molecular weight heparin (LMWH) on severe COVID-19 patients. Methods: This study was performed retrospectively in intensive care unit of a tertiary referral hospital. PCR (polymerase chain reaction) positive (+) patients were included in the study. Patients’ demographic data, length of stay in the hospital and intensive care unit, laboratory values (D-dimer, CRP, creatinine) on the last day of intensive care stay, mortality and invasive mechanical ventilator needs were recorded. Group O: consisted of patients not receiving anticoagulants, and Group 1 received a single daily dose of 40 mg enoxaparin sodium (equivalent to 4000 anti-Xa IU), and Group 2 received 2 daily doses of 1 mg/kg enoxaparin sodium. Results: A total of 191 patients were included in the study. 45% of the patients were female (n: 86), 55% were male. The mean age was found to be 67.6 ± 13.8. Patient numbers;group 0: 12, group 1: 90, group 2: 89. 7-day mortality was 50% in group 0, 22.2% in group 2, and 23.5% in group 3 (p value <0.05). Conclusion: In a recent lung dissection report in critically ill patient with COVID-19;occlusion of pulmonary small vessels and formation of microthrombosis have been demonstrated. Prophylactic doses of LMWH are used more frequently. Some studies have suggested that septic patients may benefit from early diagnosis and specific treatment. As a result;in severe COVID-19 patients with limited mobilization, all doses of LMWH reduce morbidity and mortality. (English) [ABSTRACT FROM AUTHOR] Amac: Şiddetli COVID-19 hastalarinda goze carpan en onemli klinik bulgu endotel hasaridir. Bu nedenle siddetli COVID-19 hastalarina antikoagulanlarin (heparin gibi) aktif olarak uygulanmasi onerilmektedir. Bu calismada amac, tedavide kullanilan DMAH doz farliliklarinin, siddetli COVID-19 hastalari uzerindeki etkilerini arastirmaktir. Yontem: Calisma, 3. basamak yogun bakim unitesinde, retrospektif olarak yapildi. PCR (Polimeraz zincir reaksiyonu) pozitif (+) hastalar calismaya dâhil edildi. Hastalarin demografik verileri, hastanede ve yogun bakimda kalis sureleri, yogun bakim yatislarinin son gunundeki laboratuvar degerleri (D-dimer, CRP, kreatinin), mortalite ile invaziv mekanik ventilator gereksinimleri kaydedildi. Grup O: antikoagulan almayan, grup 1: gunde 1 doz enoksaparin sodyum: 40 mg (4000 anti-Xa IU’ya esdeger), grup 2: gunde 2 doz enoksaparin sodyum: 1 mg/kg alan hastalardan olusuyordu. Bulgular: Calismaya toplam 191 hasta dâhil edildi. Hastalardan %45’i kadin (n:86), %55’i erkekti. Ortalama yas 67.6±13.8 olarak bulundu. Hasta sayilari;Grup 0: 12, Grup 1: 90, Grup 2: 89 idi. Grup 0’da 7 gunluk mortalite %50, Grup 2’de %22,2, Grup 3’te %23,5 olarak saptandi (p degeri <0,05). Sonuc: COVID-19’lu kritik hastada yapilan yakin tarihli bir akciger diseksiyonu raporunda;pulmoner kucuk damarlari tikanma ve mikrotromboz olusumu gosterilmistir. DMAH’in profilaktik dozlari daha sik kullanilmaktadir. Bazi calismalarda, septik hastalarin erken teshis ve spesifik tedaviden yarar saglayabilecegi one surulmustur. Sonuc olarak, mobilizasyonu sinirli olan agir COVID-19 hastalarinda DMAH’in tum dozlari morbidite ve mortaliteyi azaltir. (Turkish) [ABSTRACT FROM AUTHOR] Copyright of Journal of the Society of Thoracic Carido-Vascular Anaesthesia & Intensive Care is the property of Gogus Kalp Damar Anestezi ve Yogun Bakim Dernegi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)