While anticoagulants such as heparin and low molecular weight heparin like enoxaparin are both being extensively used for therapeutic mitigation of Covid-19 predisposed bleeding disorder called coagulopathy (CAC), their differences in clinical outcomes remain to be investigated.
According to a new study conducted by a team of researchers, Covid-19 patients that were treated with enoxaparin were reported to have lower mortality rates, lower ICU admission rates, and shorter hospital or ICU stays. Study findings published in a preprint journal, medRxiv.
𝗧𝗶𝘁𝗹𝗲: Enoxaparin is associated with lower rates of thrombosis, kidney injury, and mortality than Unfractionated Heparin in hospitalized COVID patients.
𝗔𝘂𝘁𝗵𝗼𝗿𝘀: Colin Pawlowski, AJ Venkatakrishnan, Christian Kirkup, Gab…https://t.co/U9mE0SZ6cc pic.twitter.com/cR3wjhzF9g
— COVID-19_arXiv (@COVID19arXiv) October 12, 2020
Coagulopathy, also called a bleeding disorder, is a chronic condition in which the blood is unable to form clots, which can predispose toward prolonged or excessive bleeding called bleeding diathesis. Coagulopathies, blood disorders are considered major clinical manifestation among Covid-19 associated blood disorder complications in clinical settings.
Previous studies gave insight of blood disorders parameters in Covid-19 patients. While multiple trials are ongoing to compare the anticoagulation treatments, there is a need for evaluation of observational data to find the better treatment option.
In the study, researchers investigated the electronic health records (EHRs) up to 671 hospitalized Covid-19 patients. They were either treated with enoxaparin or unfractionated heparin, but not both. Study was a comparative analysis of the patient outcomes in terms of mortality status, hospitalization, and the durations of stay in ICU.
To compare the impact of administered Heparin vs. Enoxaparin in severe Covid-19 patients, “propensity score” was used to determine the clinical covariates, including demographics, comorbidities, admission diagnosis, initial ICU status, and initial level of oxygen support.
Study showed that those Covid-19 infected patients who were given unfractionated heparin but not enoxaparin, reported higher mortality rates, acute kidney injury, and bacterial pneumonia, relative to patients who were treated with enoxaparin but not unfractionated heparin.
The results reported were statistically significant, emphasizing the need for mechanistically investigating differential modulation of the Covid-19 associated blood disorders.
Nevertheless, research findings indicate that the enoxaparin may be more efficacious than heparin in some conditions such as for the treatment of acute coronary syndromes. These findings further highlight the possibility of biological underpinning to the observations reported in the present work.
Collectively, these results indicated that there is a need for future studies and trials to intervene a better developmental and more efficacious standard of practice in regard to administration of anticoagulants in Covid-19 patients.