PMID- 35471480
OWN - NLM
STAT- MEDLINE
DCOM- 20220428
LR  - 20220803
IS  - 2542-5641 (Electronic)
IS  - 0366-6999 (Print)
IS  - 0366-6999 (Linking)
VI  - 135
IP  - 6
DP  - 2022 Mar 20
TI  - Low molecular weight heparin reduces arterial blood lactic acid content and 
      increases estimated glomerular filtration rate in patients with moderate Covid-19 
      pneumonia.
PG  - 691-696
LID - 10.1097/CM9.0000000000001923 [doi]
AB  - BACKGROUND: Coronavirus disease 2019 (Covid-19) remains a serious health threat 
      worldwide. We aimed to investigate whether low molecular weight heparin (LMWH) 
      can promote organ function recovery in moderate Covid-19 pneumonia patients. 
      METHODS: We initiated an LMWH protocol in Covid-19 patients with increased 
      D-dimer, body mass index >30 kg/m2 or a history of diabetes from January 18, 2020 
      at Shanghai Public Health Clinical Center. In this retrospective study, we 
      assigned moderate Covid- 19 pneumonia patients admitted between January 18th and 
      April 18, 2020 receiving the LMWH protocol to the LMWH group. Moderate patients 
      who met the inclusion criteria but did not receive LMWH protocol were included in 
      the control group by 1:2 propensity score matching. General clinical information, 
      indicators for renal function, arterial blood gas analyses, arterial blood lactic 
      acid content (mmol/L), and coagulation indexes at 0 day, 3 days, 7 days, and 11 
      days after admission were recorded and compared between the two groups. RESULTS: 
      There were 41 patients in the LMWH group and 82 patients in the control group. 
      General information in both groups were similar. Compared to the control group, 
      the arterial blood lactic acid content (mmol/L) at day 11 (1.3 [1.1, 1.7] vs. 1.2 
      [0.9, 1.3], P = 0.016) was reduced in the LMWH group. The estimated glomerular 
      filtration rate (eGFR) in the LMWH group was higher than that in the control 
      group at day 7 (108.54 [89.11, 128.17] vs. 116.85 [103.39, 133.47], P = 0.039) 
      and day 11 (113.74 [94.49, 126.34] vs. 128.31 [112.75, 144, 12], P  = 0.003). The 
      serum creatinine levels (Scr) in the LMWH group were lower than that in the 
      control group at day 7 (62.13 [51.47, 77.64] vs. 55.49 [49.50, 65.75], P = 0.038) 
      and day 11 (63.35 [50.17, 75.73] vs. 51.62 [44.62, 61.24], P = 0.005). 
      CONCLUSIONS: LMWH treatment can reduce arterial blood lactic acid levels and 
      improve eGFR in moderate Covid-19 pneumonia patients. Randomized controlled 
      trials are warranted to further investigate this issue. TRIAL REGISTRATION: 
      ChiCTR.org.cn, ChiCTR2000034796.
CI  - Copyright (c) 2022 The Chinese Medical Association, produced by Wolters Kluwer, 
      Inc. under the CC-BY-NC-ND license.
FAU - Ma, Li
AU  - Ma L
AD  - Emergency Department of Ruijin Hospital, School of Medicine, Shanghai Jiao Tong 
      University, Shanghai 200025, China.
FAU - Zeng, Yigang
AU  - Zeng Y
AD  - Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China.
FAU - Zhao, Bing
AU  - Zhao B
AD  - Emergency Department of Ruijin Hospital, School of Medicine, Shanghai Jiao Tong 
      University, Shanghai 200025, China.
FAU - Xu, Lili
AU  - Xu L
AD  - Emergency Department of Ruijin Hospital, School of Medicine, Shanghai Jiao Tong 
      University, Shanghai 200025, China.
FAU - Li, Jian
AU  - Li J
AD  - Clinical Research Center in Ruijin Hospital, School of Medicine, Shanghai Jiao 
      Tong University, Shanghai 200025, China.
FAU - Zhu, Tongyu
AU  - Zhu T
AD  - Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China.
FAU - Mao, Enqiang
AU  - Mao E
AD  - Emergency Department of Ruijin Hospital, School of Medicine, Shanghai Jiao Tong 
      University, Shanghai 200025, China.
LA  - eng
PT  - Journal Article
DEP - 20220320
PL  - China
TA  - Chin Med J (Engl)
JT  - Chinese medical journal
JID - 7513795
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 33X04XA5AT (Lactic Acid)
SB  - IM
MH  - *COVID-19
MH  - China
MH  - Glomerular Filtration Rate
MH  - *Heparin, Low-Molecular-Weight/therapeutic use
MH  - Humans
MH  - Lactic Acid
MH  - Retrospective Studies
PMC - PMC9276367
COIS- The authors declare no conflict of interest regarding the publication of the 
      article.
EDAT- 2022/04/27 06:00
MHDA- 2022/04/29 06:00
PMCR- 2022/03/03
CRDT- 2022/04/26 12:51
PHST- 2021/11/05 00:00 [received]
PHST- 2022/04/26 12:51 [entrez]
PHST- 2022/04/27 06:00 [pubmed]
PHST- 2022/04/29 06:00 [medline]
PHST- 2022/03/03 00:00 [pmc-release]
AID - 00029330-202203200-00009 [pii]
AID - CMJ-2020-3558 [pii]
AID - 10.1097/CM9.0000000000001923 [doi]
PST - epublish
SO  - Chin Med J (Engl). 2022 Mar 20;135(6):691-696. doi: 10.1097/CM9.0000000000001923.