Should COVID-19 patients be treated with low molecular weight heparin (LMWH)?

Bottom Line:

The study concluded that intermediate doses of LMWH in COVID-19 patients is feasible and safe, even in elderly patients with chronic kidney disease.

Reference:

Mattioli, M. et al. Safety of intermediate dose of low molecular weight heparin in COVID-19 patients. J Throm Thrombolysis (2020). https://doi.org/10.1007/s11239-020-02243-z

Date Published:

13 August 2020

Synopsis:

Based on past autopsy studies, patients infected with COVID-19 have an increased tendency towards blood clotting (coagulation), also known as a hypercoagulable state. It is hypothesized that this is due to extensive inflammation caused by infection resulting in dysfunction to the layer of cells that line the surface of blood vessels, also known as the endothelium. Literature discovered that anticoagulation therapy has been associated with better outcomes in COVID-19 patients but requires a higher dose in order to be effective. Thus, this study looked into the feasibility and safety of treating COVID-19 patients with an intermediate dose of LMWH. Patient data was gathered from medical records and confirmed to have COVID-19 related pneumonia through X-ray findings. In this cohort, the risk of bleeding was low (2%) and found that LMWH was feasible and safe even in patients with chronic kidney disease as no major bleeding events occurred in this population. Thus, LMWH could be an effective treatment to prevent complications caused by blood clots.

Summary by: Eugenia Yeung