Περίληψη:
Background/Aim: To investigate the efficacy (prognosis, coagulation/inflammation biomarkers) and safety (bleeding events) of different anticoagulation dosages in COVID-19 inpatients. Patients and Methods: COVID-19 inpatients (Athens, Greece) were included. The "Enhanced dose THRomboprophylaxis in Admissions (ETHRA)" protocol was applied in certain Departments, suggesting the use of intermediate anticoagulation dosage. The primary endpoint was a composite of intubation/venous thromboembolism/death. Inflammation/coagulation parameters were assessed. Results: Among 127 admissions, 95 fulfilled the inclusion criteria. Twenty-one events (4 deaths, 17 intubations) were observed. Regression analysis demonstrated significant reduction of events with intermediate or therapeutic dosage [HR=0.16 (95%CI=0.05-0.52) p=0.002; HR=0.17 (0.04-0.71) p=0.015, respectively]. D-Dimer values were higher in those who met the composite endpoint. Intermediate dosage treatment was associated with decreased values of ferritin. Three patients (3%) had minor hemorrhagic complications. Conclusion: Anticoagulation treatment (particularly intermediate dosage) appears to have positive impact on COVID-19 inpatients' prognosis by inhibiting both coagulation and inflammatory cascades. © 2021 International Institute of Anticancer Research. All rights reserved.
Συγγραφείς:
Poulakou, G.
Dimakakos, E.
Kollias, A.
Kyriakoulis, K.G.
Rapti, V.
Trontzas, I.
Thanos, C.
Abdelrasoul, M.
Vantana, T.
Leontis, K.
Kakalou, E.
Argyraki, K.
Baraboutis, I.
Michelakis, E.
Giamarellos-Bourboulis, E.
Dimakou, K.
Tsoukalas, G.
Rapti, A.
Michelakis, E.D.
Syrigos, K.N.
Λέξεις-κλειδιά:
anticoagulant agent; azithromycin; D dimer; enoxaparin; ferritin; fondaparinux; hydroxychloroquine; lopinavir plus ritonavir; low molecular weight heparin; oxygen; remdesivir; tinzaparin; anticoagulant agent, adult; anticoagulant therapy; antiviral therapy; Article; atrial fibrillation; bleeding; clinical article; computed tomographic angiography; controlled study; coronavirus disease 2019; deep vein thrombosis; drug safety; drug withdrawal; enzyme linked immunosorbent assay; epistaxis; female; follow up; glomerulus filtration rate; Greece; hemoptysis; heparinization; human; limit of detection; lung angiography; lung embolism; male; medical record review; middle aged; oxygen saturation; prognosis; respiratory tract intubation; retrospective study; risk factor; therapeutic dose; thrombophilia; thrombosis prevention; venous thromboembolism; aged; blood; blood clotting; dose response; drug effect; hospital patient; hospitalization; isolation and purification; physiology; prevention and control; treatment outcome; venous thromboembolism; very elderly; virology, Adult; Aged; Aged, 80 and over; Anticoagulants; Blood Coagulation; COVID-19; Dose-Response Relationship, Drug; Female; Greece; Hospitalization; Humans; Inpatients; Male; Middle Aged; Retrospective Studies; SARS-CoV-2; Treatment Outcome; Venous Thromboembolism
