PMID- 33412596
OWN - NLM
STAT- MEDLINE
DCOM- 20210805
LR  - 20221207
IS  - 2567-689X (Electronic)
IS  - 0340-6245 (Linking)
VI  - 121
IP  - 8
DP  - 2021 Aug
TI  - Heparin in COVID-19 Patients Is Associated with Reduced In-Hospital Mortality: 
      The Multicenter Italian CORIST Study.
PG  - 1054-1065
LID - 10.1055/a-1347-6070 [doi]
AB  - INTRODUCTION: A hypercoagulable condition was described in patients with 
      coronavirus disease 2019 (COVID-19) and proposed as a possible pathogenic 
      mechanism contributing to disease progression and lethality. AIM: We evaluated if 
      in-hospital administration of heparin improved survival in a large cohort of 
      Italian COVID-19 patients. METHODS: In a retrospective observational study, 2,574 
      unselected patients hospitalized in 30 clinical centers in Italy from February 
      19, 2020 to June 5, 2020 with laboratory-confirmed severe acute respiratory 
      syndrome coronavirus-2 infection were analyzed. The primary endpoint in a time-to 
      event analysis was in-hospital death, comparing patients who received heparin 
      (low-molecular-weight heparin [LMWH] or unfractionated heparin [UFH]) with 
      patients who did not. We used multivariable Cox proportional-hazards regression 
      models with inverse probability for treatment weighting by propensity scores. 
      RESULTS: Out of 2,574 COVID-19 patients, 70.1% received heparin. LMWH was largely 
      the most used formulation (99.5%). Death rates for patients receiving heparin or 
      not were 7.4 and 14.0 per 1,000 person-days, respectively. After adjustment for 
      propensity scores, we found a 40% lower risk of death in patients receiving 
      heparin (hazard ratio = 0.60; 95% confidence interval: 0.49-0.74; 
      E-value = 2.04). This association was particularly evident in patients with a 
      higher severity of disease or strong coagulation activation. CONCLUSION: 
      In-hospital heparin treatment was associated with a lower mortality, particularly 
      in severely ill COVID-19 patients and in those with strong coagulation 
      activation. The results from randomized clinical trials are eagerly awaited to 
      provide clear-cut recommendations.
CI  - Thieme. All rights reserved.
FAU - Di Castelnuovo, Augusto
AU  - Di Castelnuovo A
AD  - Mediterranea Cardiocentro, Napoli, Italy.
FAU - Costanzo, Simona
AU  - Costanzo S
AUID- ORCID: 0000-0003-4569-1186
AD  - Department of Epidemiology and Prevention, IRCCS Neuromed, Pozzilli, Isernia, 
      Italy.
FAU - Antinori, Andrea
AU  - Antinori A
AD  - UOC Immunodeficienze Virali, National Institute for Infectious Diseases "L. 
      Spallanzani," IRCCS, Rome, Italy.
FAU - Berselli, Nausicaa
AU  - Berselli N
AD  - Section of Public Health, Department of Biomedical, Metabolic and Neural 
      Sciences, University of Modena and Reggio Emilia, Modena, Italy.
FAU - Blandi, Lorenzo
AU  - Blandi L
AD  - Universita di Pavia, Pavia, Italy.
FAU - Bonaccio, Marialaura
AU  - Bonaccio M
AD  - Department of Epidemiology and Prevention, IRCCS Neuromed, Pozzilli, Isernia, 
      Italy.
FAU - Cauda, Roberto
AU  - Cauda R
AD  - Fondazione Policlinico Universitario A, Gemelli IRCCS, Rome, Italy.
AD  - Dipartimento di Sicurezza e Bioetica Sede di Roma, Universita Cattolica del Sacro 
      Cuore, Rome, Italy.
FAU - Guaraldi, Giovanni
AU  - Guaraldi G
AD  - Infectious Disease Unit, Department of Surgical, Medical, Dental and 
      Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy.
FAU - Menicanti, Lorenzo
AU  - Menicanti L
AD  - IRCCS Policlinico San Donato, San Donato, Milanese (MI), Italy.
FAU - Mennuni, Marco
AU  - Mennuni M
AD  - University of Eastern Piedmont, Maggiore della Carita Hospital, Novara, Italy.
FAU - Parruti, Giustino
AU  - Parruti G
AD  - Department of Infectious Disease, Azienda Sanitaria Locale (AUSL) di Pescara, 
      Pescara, Italy.
FAU - Patti, Giuseppe
AU  - Patti G
AD  - University of Eastern Piedmont, Maggiore della Carita Hospital, Novara, Italy.
FAU - Santilli, Francesca
AU  - Santilli F
AD  - Department of Medicine and Aging, Clinica Medica, "SS. Annunziata" Hospital and 
      University of Chieti, Chieti, Italy.
FAU - Signorelli, Carlo
AU  - Signorelli C
AD  - School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.
FAU - Vergori, Alessandra
AU  - Vergori A
AD  - Department of HIV/AIDS, National Institute for Infectious Diseases "Lazzaro 
      Spallanzani"-IRCCS, Rome, Italy.
FAU - Abete, Pasquale
AU  - Abete P
AD  - Dipartimento di Scienze Mediche Traslazionali, Universita degli studi di Napoli 
      "Federico II," Napoli, Italy.
FAU - Ageno, Walter
AU  - Ageno W
AD  - Department of Medicine and Surgery, University of Insubria, Varese, Italy.
FAU - Agodi, Antonella
AU  - Agodi A
AD  - Department of Medical and Surgical Sciences and Advanced Technologies "G.F. 
      Ingrassia," University of Catania; AOU Policlinico "G. Rodolico - San Marco," 
      Catania, Italy.
FAU - Agostoni, Piergiuseppe
AU  - Agostoni P
AD  - Centro Cardiologico Monzino IRCCS, Milan, Italy.
AD  - Section of Cardiovascular, Department of Clinical Sciences and Community Health, 
      University of Milano, Milan, Italy.
FAU - Aiello, Luca
AU  - Aiello L
AD  - UOC, Anestesia e Rianimazione, Dipartimento di Chirurgia Generale Ospedale 
      Morgagni-Pierantoni, Forli, Italy.
FAU - Al Moghazi, Samir
AU  - Al Moghazi S
AD  - UOC Infezioni Sistemiche dell'Immunodepresso, National Institute for Infectious 
      Diseases L. Spallanzani, IRCCS, Rome, Italy.
FAU - Arboretti, Rosa
AU  - Arboretti R
AD  - Department of Civil Environmental and Architectural Engineering, University of 
      Padova, Padova, Italy.
FAU - Astuto, Marinella
AU  - Astuto M
AD  - Department of General Surgery and Medical-Surgical Specialties, University of 
      Catania, U.O. Anestesia, Rianimazione 1. P.O. "G. Rodolico," AOU Policlinico "G. 
      Rodolico - San Marco," Catania, Italy.
FAU - Aucella, Filippo
AU  - Aucella F
AD  - Fondazione I.R.C.C.S "Casa Sollievo della Sofferenza," San Giovanni Rotondo, 
      Foggia, Italy.
FAU - Barbieri, Greta
AU  - Barbieri G
AD  - Department of Surgical, Medical and Molecular Medicine and Critical Care, Azienda 
      Ospedaliera Universitaria Pisana, University of Pisa, Pisa, Italy.
FAU - Bartoloni, Alessandro
AU  - Bartoloni A
AD  - Department of Experimental and Clinical Medicine, University of Florence and 
      Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy.
FAU - Bonfanti, Paolo
AU  - Bonfanti P
AD  - UOC Malattie Infettive, Ospedale San Gerardo, ASST Monza, Monza, Italy.
AD  - School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.
FAU - Cacciatore, Francesco
AU  - Cacciatore F
AD  - Dipartimento di Scienze Mediche Traslazionali, Universita degli studi di Napoli 
      "Federico II," Napoli, Italy.
FAU - Caiano, Lucia
AU  - Caiano L
AD  - Department of Medicine and Surgery, University of Insubria, Varese, Italy.
FAU - Carrozzi, Laura
AU  - Carrozzi L
AD  - Cardiovascular and Thoracic Department, Azienda Ospedaliero-Universitaria Pisana 
      and University of Pisa, Pisa, Italy.
FAU - Cascio, Antonio
AU  - Cascio A
AD  - Infectious and Tropical Diseases Unit, Department of Health Promotion, Mother and 
      Child Care, Internal Medicine and Medical Specialties (PROMISE), University of 
      Palermo, Palermo, Italy.
FAU - Ciccullo, Arturo
AU  - Ciccullo A
AD  - Fondazione Policlinico Universitario A, Gemelli IRCCS, Rome, Italy.
FAU - Cingolani, Antonella
AU  - Cingolani A
AD  - Fondazione Policlinico Universitario A, Gemelli IRCCS, Rome, Italy.
AD  - Dipartimento di Sicurezza e Bioetica Sede di Roma, Universita Cattolica del Sacro 
      Cuore, Rome, Italy.
FAU - Cipollone, Francesco
AU  - Cipollone F
AD  - Department of Medicine and Aging, Clinica Medica, "SS. Annunziata" Hospital and 
      University of Chieti, Chieti, Italy.
FAU - Colomba, Claudia
AU  - Colomba C
AD  - Infectious and Tropical Diseases Unit, Department of Health Promotion, Mother and 
      Child Care, Internal Medicine and Medical Specialties (PROMISE), University of 
      Palermo, Palermo, Italy.
FAU - Colombo, Crizia
AU  - Colombo C
AD  - University of Eastern Piedmont, Maggiore della Carita Hospital, Novara, Italy.
FAU - Crosta, Francesca
AU  - Crosta F
AD  - Department of Infectious Disease, Azienda Sanitaria Locale (AUSL) di Pescara, 
      Pescara, Italy.
FAU - Danzi, Gian Battista
AU  - Danzi GB
AD  - Department of Cardiology, Ospedale di Cremona, Cremona, Italy.
FAU - D'Ardes, Damiano
AU  - D'Ardes D
AD  - Department of Medicine and Aging, Clinica Medica, "SS. Annunziata" Hospital and 
      University of Chieti, Chieti, Italy.
FAU - de Gaetano Donati, Katleen
AU  - de Gaetano Donati K
AD  - Fondazione Policlinico Universitario A, Gemelli IRCCS, Rome, Italy.
FAU - Di Gennaro, Francesco
AU  - Di Gennaro F
AD  - Medical Direction, IRCCS Neuromed, Pozzilli, Isernia, Italy.
FAU - Di Tano, Giuseppe
AU  - Di Tano G
AD  - Department of Cardiology, Ospedale di Cremona, Cremona, Italy.
FAU - D'Offizi, Gianpiero
AU  - D'Offizi G
AD  - UOC Malattie Infettive-Epatologia, National Institute for Infectious Diseases L, 
      Spallanzani, IRCCS, Roma, Italy.
FAU - Fantoni, Massimo
AU  - Fantoni M
AD  - Fondazione Policlinico Universitario A, Gemelli IRCCS, Rome, Italy.
AD  - Dipartimento di Sicurezza e Bioetica Sede di Roma, Universita Cattolica del Sacro 
      Cuore, Rome, Italy.
FAU - Fusco, Francesco Maria
AU  - Fusco FM
AD  - UOC Infezioni Sistemiche e dell'Immunodepresso, Azienda Ospedaliera dei Colli, 
      Ospedale Cotugno, Napoli, Italy.
FAU - Gentile, Ivan
AU  - Gentile I
AD  - Department of Clinical Medicine and Surgery, University of Naples Federico II, 
      Napoli, Italy.
FAU - Gianfagna, Francesco
AU  - Gianfagna F
AD  - Mediterranea Cardiocentro, Napoli, Italy.
AD  - Department of Medicine and Surgery, University of Insubria, Varese, Italy.
FAU - Grandone, Elvira
AU  - Grandone E
AD  - Fondazione I.R.C.C.S "Casa Sollievo della Sofferenza," San Giovanni Rotondo, 
      Foggia, Italy.
FAU - Graziani, Emauele
AU  - Graziani E
AD  - Medicina Interna, Ospedale di Ravenna, AUSL della Romagna, Ravenna, Italy.
FAU - Grisafi, Leonardo
AU  - Grisafi L
AD  - University of Eastern Piedmont, Maggiore della Carita Hospital, Novara, Italy.
FAU - Guarnieri, Gabriella
AU  - Guarnieri G
AD  - Division of Respiratory Pathophysiology, Department of Cardiologic, Thoracic and 
      Vascular Sciences, University of Padova, Padova, Italy.
FAU - Larizza, Giovanni
AU  - Larizza G
AD  - COVID-19 Unit, EE Ospedale Regionale F. Miulli, Acquaviva delle Fonti, Bari, 
      Italy.
FAU - Leone, Armando
AU  - Leone A
AD  - UOC di Pneumologia, P.O. San Giuseppe Moscati, Taranto, Italy.
FAU - Maccagni, Gloria
AU  - Maccagni G
AD  - Department of Cardiology, Ospedale di Cremona, Cremona, Italy.
FAU - Madaro, Ferruccio
AU  - Madaro F
AD  - COVID-19 Unit, EE Ospedale Regionale F. Miulli, Acquaviva delle Fonti, Bari, 
      Italy.
FAU - Maitan, Stefano
AU  - Maitan S
AD  - UOC, Anestesia e Rianimazione, Dipartimento di Chirurgia Generale Ospedale 
      Morgagni-Pierantoni, Forli, Italy.
FAU - Mancarella, Sandro
AU  - Mancarella S
AD  - ASST Milano Nord, Ospedale Edoardo Bassini Cinisello Balsamo, Milan, Italy.
FAU - Mapelli, Massimo
AU  - Mapelli M
AD  - Centro Cardiologico Monzino IRCCS, Milan, Italy.
AD  - Section of Cardiovascular, Department of Clinical Sciences and Community Health, 
      University of Milano, Milan, Italy.
FAU - Maragna, Riccardo
AU  - Maragna R
AD  - Centro Cardiologico Monzino IRCCS, Milan, Italy.
AD  - Section of Cardiovascular, Department of Clinical Sciences and Community Health, 
      University of Milano, Milan, Italy.
FAU - Marcucci, Rossella
AU  - Marcucci R
AD  - Department of Experimental and Clinical Medicine, University of Florence and 
      Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy.
FAU - Maresca, Giulio
AU  - Maresca G
AD  - UOC di Medicina - Presidio Ospedaliero S. Maria di Loreto Nuovo. ASL Napoli 1 
      Centro. Napoli. Italy.
FAU - Marongiu, Silvia
AU  - Marongiu S
AD  - P.O. Santissima Trinita di Cagliari, Cagliari, Italy.
FAU - Marotta, Claudia
AU  - Marotta C
AD  - Medical Direction, IRCCS Neuromed, Pozzilli, Isernia, Italy.
FAU - Marra, Lorenzo
AU  - Marra L
AD  - UOC di Pneumologia, P.O. San Giuseppe Moscati, Taranto, Italy.
FAU - Mastroianni, Franco
AU  - Mastroianni F
AD  - COVID-19 Unit, EE Ospedale Regionale F. Miulli, Acquaviva delle Fonti, Bari, 
      Italy.
FAU - Mazzitelli, Maria
AU  - Mazzitelli M
AD  - Infectious and Tropical Diseases Unit, Department of Medical and Surgical 
      Sciences "Magna Graecia" University, Catanzaro, Italy.
FAU - Mengozzi, Alessandro
AU  - Mengozzi A
AD  - Department of Clinical and Experimental Medicine, Azienda Ospedaliera 
      Universitaria Pisana, University of Pisa, Pisa, Italy.
FAU - Menichetti, Francesco
AU  - Menichetti F
AD  - Department of Clinical and Experimental Medicine, Azienda Ospedaliera 
      Universitaria Pisana, University of Pisa, Pisa, Italy.
FAU - Meschiari, Marianna
AU  - Meschiari M
AD  - Infectious Disease Unit, Department of Surgical, Medical, Dental and 
      Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy.
FAU - Milic, Jovana
AU  - Milic J
AD  - Infectious Disease Unit, Department of Surgical, Medical, Dental and 
      Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy.
FAU - Minutolo, Filippo
AU  - Minutolo F
AD  - Dipartimento di Farmacia, Universita di Pisa, Pisa, Italy.
FAU - Molena, Beatrice
AU  - Molena B
AD  - Division of Respiratory Pathophysiology, Department of Cardiologic, Thoracic and 
      Vascular Sciences, University of Padova, Padova, Italy.
FAU - Montineri, Arturo
AU  - Montineri A
AD  - U.O. C. Malattie Infettive e Tropicali, P.O. "San Marco." AOU Policlinico "G. 
      Rodolico - San Marco," Catania, Italy.
FAU - Mussini, Cristina
AU  - Mussini C
AD  - Infectious Disease Unit, Department of Surgical, Medical, Dental and 
      Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy.
FAU - Musso, Maria
AU  - Musso M
AD  - UOC Malattie Infettive-Apparato Respiratorio, National Institute for Infectious 
      Diseases "L. Spallanzani," IRCCS, Rome, Italy.
FAU - Niola, Daniela
AU  - Niola D
AD  - Department of Medicine and Aging, Clinica Medica, "SS. Annunziata" Hospital and 
      University of Chieti, Chieti, Italy.
FAU - Odone, Anna
AU  - Odone A
AD  - Universita di Pavia, Pavia, Italy.
FAU - Olivieri, Marco
AU  - Olivieri M
AD  - Computer Service, University of Molise, Campobasso, Italy.
FAU - Palimodde, Antonella
AU  - Palimodde A
AD  - P.O. Santissima Trinita di Cagliari, Cagliari, Italy.
FAU - Parisi, Roberta
AU  - Parisi R
AD  - Department of Epidemiology and Prevention, IRCCS Neuromed, Pozzilli, Isernia, 
      Italy.
FAU - Pasi, Emanuela
AU  - Pasi E
AD  - Medicina Interna, Ospedale di Ravenna, AUSL della Romagna, Ravenna, Italy.
FAU - Pesavento, Raffaele
AU  - Pesavento R
AD  - Clinica Medica 3, Department of Medicine - DIMED, University hospital of Padova, 
      Padova, Italy.
FAU - Petri, Francesco
AU  - Petri F
AD  - UOC Malattie Infettive, Ospedale San Gerardo, ASST Monza, Monza, Italy.
FAU - Pinchera, Biagio
AU  - Pinchera B
AD  - Department of Clinical Medicine and Surgery, University of Naples Federico II, 
      Napoli, Italy.
FAU - Poletti, Venerino
AU  - Poletti V
AD  - UOC Pneumologia, Dipartimento di Malattie Apparato Respiratorio e Torace, 
      Ospedale Morgagni-Pierantoni, Forli, Italy.
AD  - Department of Respiratory Diseases and Allergy, Aarhus University Hospital, 
      Aarhus, Denmark.
FAU - Ravaglia, Claudia
AU  - Ravaglia C
AD  - UOC Pneumologia, Dipartimento di Malattie Apparato Respiratorio e Torace, 
      Ospedale Morgagni-Pierantoni, Forli, Italy.
FAU - Rognoni, Andrea
AU  - Rognoni A
AD  - University of Eastern Piedmont, Maggiore della Carita Hospital, Novara, Italy.
FAU - Rossato, Marco
AU  - Rossato M
AD  - Clinica Medica 3, Department of Medicine - DIMED, University hospital of Padova, 
      Padova, Italy.
FAU - Rossi, Marianna
AU  - Rossi M
AD  - UOC Malattie Infettive, Ospedale San Gerardo, ASST Monza, Monza, Italy.
FAU - Sangiovanni, Vincenzo
AU  - Sangiovanni V
AD  - UOC Infezioni Sistemiche e dell'Immunodepresso, Azienda Ospedaliera dei Colli, 
      Ospedale Cotugno, Napoli, Italy.
FAU - Sanrocco, Carlo
AU  - Sanrocco C
AD  - Department of Infectious Disease, Azienda Sanitaria Locale (AUSL) di Pescara, 
      Pescara, Italy.
FAU - Scorzolini, Laura
AU  - Scorzolini L
AD  - UOC Malattie Infettive ad Alta Intensita di Cura, National Institute for 
      Infectious Diseases "L. Spallanzani," IRCCS, Rome, Italy.
FAU - Sgariglia, Raffaella
AU  - Sgariglia R
AD  - ASST Milano Nord, Ospedale Edoardo Bassini Cinisello Balsamo, Milan, Italy.
FAU - Simeone, Paola Giustina
AU  - Simeone PG
AD  - Department of Infectious Disease, Azienda Sanitaria Locale (AUSL) di Pescara, 
      Pescara, Italy.
FAU - Taddei, Eleonora
AU  - Taddei E
AD  - Fondazione Policlinico Universitario A, Gemelli IRCCS, Rome, Italy.
FAU - Torti, Carlo
AU  - Torti C
AD  - Infectious and Tropical Diseases Unit, Department of Medical and Surgical 
      Sciences "Magna Graecia" University, Catanzaro, Italy.
FAU - Vettor, Roberto
AU  - Vettor R
AD  - Clinica Medica 3, Department of Medicine - DIMED, University hospital of Padova, 
      Padova, Italy.
FAU - Vianello, Andrea
AU  - Vianello A
AD  - Division of Respiratory Pathophysiology, Department of Cardiologic, Thoracic and 
      Vascular Sciences, University of Padova, Padova, Italy.
FAU - Vinceti, Marco
AU  - Vinceti M
AD  - Section of Public Health, Department of Biomedical, Metabolic and Neural 
      Sciences, University of Modena and Reggio Emilia, Modena, Italy.
AD  - Department of Epidemiology, Boston University School of Public Health, Boston, 
      Massachusetts, United States.
FAU - Virano, Alexandra
AU  - Virano A
AD  - Department of Medicine and Surgery, University of Insubria, Varese, Italy.
FAU - Vocciante, Laura
AU  - Vocciante L
AD  - UOC di Medicina - Presidio Ospedaliero S. Maria di Loreto Nuovo. ASL Napoli 1 
      Centro. Napoli. Italy.
FAU - De Caterina, Raffaele
AU  - De Caterina R
AD  - Cardiovascular and Thoracic Department, Azienda Ospedaliero-Universitaria Pisana 
      and University of Pisa, Pisa, Italy.
FAU - Iacoviello, Licia
AU  - Iacoviello L
AD  - Department of Epidemiology and Prevention, IRCCS Neuromed, Pozzilli, Isernia, 
      Italy.
AD  - Department of Medicine and Surgery, University of Insubria, Varese, Italy.
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
DEP - 20210228
PL  - Germany
TA  - Thromb Haemost
JT  - Thrombosis and haemostasis
JID - 7608063
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Aged
MH  - Anticoagulants/*therapeutic use
MH  - Blood Coagulation/drug effects
MH  - COVID-19/blood/*complications
MH  - Female
MH  - Heparin/*therapeutic use
MH  - Heparin, Low-Molecular-Weight/*therapeutic use
MH  - Hospital Mortality
MH  - Humans
MH  - Italy/epidemiology
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Survival Analysis
MH  - Thrombophilia/blood/*etiology/*prevention & control
MH  - COVID-19 Drug Treatment
COIS- None declared.
EDAT- 2021/01/08 06:00
MHDA- 2021/08/06 06:00
CRDT- 2021/01/07 20:19
PHST- 2021/01/07 00:00 [aheadofprint]
PHST- 2021/01/08 06:00 [pubmed]
PHST- 2021/08/06 06:00 [medline]
PHST- 2021/01/07 20:19 [entrez]
AID - 10.1055/a-1347-6070 [doi]
PST - ppublish
SO  - Thromb Haemost. 2021 Aug;121(8):1054-1065. doi: 10.1055/a-1347-6070. Epub 2021 
      Feb 28.