• Saudi Med J · Jul 2022

    The effect of low-dose and high-dose low-molecular-weight-heparin and aspirin thromboprophylaxis on clinical outcome and mortality in critical ill patients with COVID-19: A retrospective cohort study.

    • Ali Eman, Onur Balaban, Kezban Ö Süner, Yaşar Cırdı, Fatih Şahin, Gürkan Demir, Özge Pekşen, Ahmet Musmul, and Ali F Erdem.
    • From the Department of Anesthesiology and Reanimation (Eman, Balaban, Şahin, Demir, Pekşen, Erdem); from the Department of Intensive Care (Süner), Sakarya Training and Research Hospital; from the Department of Intensive Care (Cırdı), faculty of Medicine, Sakarya University, Sakarya; and from the Department of Medical Services and Techniques (Musmul), Eskisehir Osmangazi University Vocational School of Health Services, Eskisehir, Turkey.
    • Saudi Med J. 2022 Jul 1; 43 (7): 715722715-722.

    ObjectivesTo assess the effect of different thromboprophylaxis regimens on clinical outcomes and mortality of critical ill patients with coronavirus disease -19 (COVID-19).MethodsWe investigated the medical records of patients with positive COVID-19 (using polymerase chain reaction test) who were admitted to the intensive care unit (ICU) at Sakarya University Hospital, Sakarya, Turkey, from March 2020 to January 2021. We included patients under anticoagulant therapy in the clinical course. The patients were allocated to 3 groups: Group A - low-dose (prophylactic) low-molecular-weight-heparin (LMWH) therapy, Group B - high-dose (therapeutic) LMWH therapy, and patients that received aspirin additional to the high-dose (therapeutic) LMWH as Group C. Primary outcomes were overall mortality rates and length of stay (LOS) in ICU. Secondary outcomes were rates of major hemorrhagic and thrombotic events.ResultsRecords of 475 patients were reviewed and 164 patients were included. No significant difference was detected in mortality rates between groups (p=0.135). Intensive care unit stay was 13 (9-24.5) days in Group A, 11 (8.75-23) days in Group B, and 13 (9-17) days in Group C without a significant difference (p=0.547). No significant difference was detected between groups in terms of thrombotic (p=0.565) and hemorrhagic events (p=0.615).ConclusionA high-dose anticoagulation therapy and addition of aspirin to LMWH therapy did not decrease the mortality rates and LOS in ICU in critical ill COVİD-19 patients. In addition, it did not increase the incidence of major hemorrhage and major thrombotic events.Copyright: © Saudi Medical Journal.

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