A recently accepted article in the Journal of Thrombosis and Haemostasis concluded that anticoagulant therapy mainly with low molecular weight heparin (LMWH) appears to be associated with better prognosis in severe COVID‐19 patients meeting SIC criteria or with markedly elevated D‐Dimer.
As the article describes, occlusion and microthrombosis formation in pulmonary small vessels of critical patients with COVID-19 has been reported from recent lung organ dissection, with the application of anticoagulant therapy in severe COVID-19 patients consequently suggested in China for improving outcomes.
In the study, the results, medications and outcomes of 449 patients having been classified as severe COVID‐19 were retrospectively analysed, with the 28‐day mortality between heparin users and non-users compared. In summary, the D‐dimer, prothrombin time and age were positively correlated with 28‐day mortality, with that of heparin users being lower than non-users in patients with ISTH sepsis‐induced coagulopathy (SIC) scores of ≥4, or D‐dimer being > 6× the upper limit of normal.
As the article concludes:
“ our study suggests that anticoagulant may not benefit to the unselected patients, instead, only the patients meeting SIC criteria or with markedly elevated D-dimer may benefit from anticoagulant therapy mainly with LMWH ”
The article is available in full on the JTH website.
Quantitative testing for deep-vein thrombosis, pulmonary embolism and more on Sysmex, IL and Behnk automated coagulation platforms, with a manual latex-based kit for rapid point-of-care use.
23 April 2020 12:30