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349710

Therapeutic versus Prophylactic Anticoagulation with Low Molecular Weight Heparin for Moderate COVID-19 Patients

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Last updated: 01 Jan 2025

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Abstract

Background: COVID-19 is linked to an increased susceptibility to thrombotic problems, but the effectiveness of therapeutic-dose anticoagulation is uncertain. The aim was to detect whether the therapeutic-dose anticoagulation improves clinical status of moderate Covid 19 patients in comparison to prophylactic dose anticoagulation.

Methods: The protocol for this trial was approved by the institutional review board of Menoufia university (trial registration No.:12/2021 ANET 23). This study is a prospective randomized comparative trial included 70 patients with moderate COVID-19 assigned into group A (receiving therapeutic anticoagulation with subcutaneous low-molecular-weight heparin (LMWH) at a dose of 1 mg/kg twice daily) and group B (receiving thromboprophylaxis with subcutaneous LMWH at a dose of 40 mg once daily). The aim was to assess the clinical status on an ordinal scale of 8 points from world health organization.

Results: Patients on group A were well matched with the patients on group B regarding the efficacy outcome (clinical status assessed by World Health Organization (WHO), laboratory data , 28-day mortality and the length of hospital stay) except the D-dimer level at week 2 that was elevated in group B than in the group A (2200 vs 1100 ng/mL, P<0.05), as well as the result of PaO2/FiO2 which were higher on week 2 in group A (190 vs 145 respectively, P<0.05).

Conclusion: The prophylactic anticoagulation had priority over the therapeutic one in the treatment of moderate COVID-19 individuals as the therapeutic dose had no impact on either the clinical status assessed by WHO scale or overall mortality rate.

DOI

10.21608/zumj.2024.279878.3290

Keywords

anticoagulation, Coagulopathy, Heparin, mortality, Thrombosis

Authors

First Name

Wafiya

Last Name

Mahdy

MiddleName

Ramadan

Affiliation

Department of Anesthesiology, Intensive care and Pain management, Faculty of Medicine, Menoufia University, Egypt

Email

wafia.mahdi@med.menofia.edu.eg

City

-

Orcid

-

First Name

Aya

Last Name

Mohammed

MiddleName

Abdelghany

Affiliation

Department of Anesthesiology, Intensive care and Pain management, Faculty of Medicine, Menoufia University, Egypt

Email

doctoraya991702@gmail.com

City

-

Orcid

-

First Name

Abdel Rahman

Last Name

Ahmed

MiddleName

Ahmed

Affiliation

Department of Anesthesiology, Intensive care and Pain management, Faculty of Medicine, Menoufia University, Egypt

Email

rahman80eg@yahoo.com

City

-

Orcid

-

First Name

Nadia

Last Name

Bahgat

MiddleName

Mohee ELdin

Affiliation

Department of Anesthesiology, Intensive care and Pain management, Faculty of Medicine, Menoufia University, Egypt

Email

dr_nmbahgat@med.menofia.edu.eg

City

-

Orcid

-

Volume

30

Article Issue

9

Related Issue

51783

Issue Date

2024-12-01

Receive Date

2024-03-27

Publish Date

2024-12-01

Page Start

4,687

Page End

4,697

Print ISSN

1110-1431

Online ISSN

2357-0717

Link

https://zumj.journals.ekb.eg/article_349710.html

Detail API

https://zumj.journals.ekb.eg/service?article_code=349710

Order

41

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Original Article

Type Code

273

Publication Type

Journal

Publication Title

Zagazig University Medical Journal

Publication Link

https://zumj.journals.ekb.eg/

MainTitle

Therapeutic versus Prophylactic Anticoagulation with Low Molecular Weight Heparin for Moderate COVID-19 Patients

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Type

Article

Created At

30 Dec 2024