PMID- 35484870
OWN - NLM
STAT- MEDLINE
DCOM- 20220502
LR  - 20221207
IS  - 1531-1937 (Electronic)
IS  - 0897-1900 (Print)
IS  - 0897-1900 (Linking)
VI  - 35
IP  - 2
DP  - 2022 Apr
TI  - Continuous Infusion Low-Dose Unfractionated Heparin for the Management of 
      Hypercoagulability Associated With COVID-19.
PG  - 205-211
LID - 10.1177/0897190020966207 [doi]
AB  - INTRODUCTION: The Coronavirus Disease 2019 (COVID-19) is associated with severe 
      hypercoagulability. There is currently limited evidence supporting the routine 
      use of therapeutic anticoagulation in the setting of COVID-19. OBJECTIVES: The 
      primary objective was to compare the incidence of thromboembolic events in adult 
      patients with COVID-19 treated with an unfractionated heparin (UFH) infusion 
      versus prophylactic dose anticoagulation. Secondary objectives included 
      exploration of the efficacy and safety of an UFH infusion through the evaluation 
      of organ function and incidence of minor and major bleeding. METHODS: 
      Retrospective observational cohort study with propensity score matching of 
      COVID-19 patients who received an UFH infusion targeting an aPTT between 40 and 
      60 seconds. RESULTS: Fifty-six patients were included in this study. There was no 
      difference in the composite of thromboembolic events comprised of venous 
      thromboembolism, arterial thrombosis, and catheter-related thrombosis between the 
      UFH and control group (17.9% vs. 3.6%, P = 0.19). There was a significant 
      increase in median D-dimer concentrations from day 1 to day 7 in the control 
      group (475 ng/mL [291-999] vs. 10820 ng/mL [606-21033], P = 0.04). Patients 
      treated with UFH had a higher incidence of minor bleeding (35.7% vs. 0%, P < 
      0.005) and required more units of packed red blood cell transfusion (0.8 units +/- 
      1.6 vs. 0 units, P = 0.01). CONCLUSION: Continuous infusion of UFH for patients 
      with COVID-19 infection did not decrease the overall incidence of thromboembolic 
      complications. UFH was associated with stabilization of D-dimer concentrations 
      and increased rates of minor bleeding and transfusions.
FAU - Li, Matthew
AU  - Li M
AUID- ORCID: 0000-0003-1320-7134
AD  - Department of Pharmacy, New York City Health + Hospitals/Queens, Jamaica, NY, 
      USA.
FAU - Gitarts, Steven
AU  - Gitarts S
AD  - Department of Medicine, 5925Icahn School of Medicine at Mount Sinai/New York City 
      Health + Hospitals/Queens, New York, NY, USA.
FAU - Nyabera, Akwe
AU  - Nyabera A
AUID- ORCID: 0000-0002-2208-9531
AD  - Department of Medicine, 5925Icahn School of Medicine at Mount Sinai/New York City 
      Health + Hospitals/Queens, New York, NY, USA.
FAU - Kondaveeti, Ravali
AU  - Kondaveeti R
AD  - Department of Medicine, 5925Icahn School of Medicine at Mount Sinai/New York City 
      Health + Hospitals/Queens, New York, NY, USA.
FAU - Hammudeh, Yousef
AU  - Hammudeh Y
AD  - Department of Medicine, 5925Icahn School of Medicine at Mount Sinai/New York City 
      Health + Hospitals/Queens, New York, NY, USA.
FAU - Gonzalez, Carlos
AU  - Gonzalez C
AD  - Department of Medicine, 5925Icahn School of Medicine at Mount Sinai/New York City 
      Health + Hospitals/Queens, New York, NY, USA.
FAU - Trandafirescu, Theo
AU  - Trandafirescu T
AD  - Department of Medicine, 5925Icahn School of Medicine at Mount Sinai/New York City 
      Health + Hospitals/Queens, New York, NY, USA.
FAU - Penumadu, Arunakumari
AU  - Penumadu A
AD  - Department of Medicine, 5925Icahn School of Medicine at Mount Sinai/New York City 
      Health + Hospitals/Queens, New York, NY, USA.
FAU - Lopez, Ricardo
AU  - Lopez R
AD  - Department of Medicine, 5925Icahn School of Medicine at Mount Sinai/New York City 
      Health + Hospitals/Queens, New York, NY, USA.
FAU - Sahibzada, Asad
AU  - Sahibzada A
AD  - Department of Medicine, 5925Icahn School of Medicine at Mount Sinai/New York City 
      Health + Hospitals/Queens, New York, NY, USA.
FAU - La Cruz, Angel De
AU  - La Cruz A
AD  - Department of Medicine, 5925Icahn School of Medicine at Mount Sinai/New York City 
      Health + Hospitals/Queens, New York, NY, USA.
FAU - Rahman, Habibur
AU  - Rahman H
AD  - Department of Medicine, 5925Icahn School of Medicine at Mount Sinai/New York City 
      Health + Hospitals/Queens, New York, NY, USA.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20201014
PL  - United States
TA  - J Pharm Pract
JT  - Journal of pharmacy practice
JID - 8900945
RN  - 0 (Anticoagulants)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Adult
MH  - Anticoagulants
MH  - Hemorrhage/chemically induced
MH  - Heparin
MH  - Humans
MH  - Retrospective Studies
MH  - *Thrombophilia/drug therapy/etiology
MH  - *Thrombosis/drug therapy/epidemiology/etiology
MH  - *Venous Thromboembolism/drug therapy/epidemiology/etiology
MH  - *COVID-19 Drug Treatment
PMC - PMC9086210
OTO - NOTNLM
OT  - COVID-19
OT  - heparin
OT  - hypercoagulable
OT  - pulmonary embolism
OT  - venous thromboembolism
COIS- Declaration of Conflicting Interests: The author(s) declared no potential 
      conflicts of interest with respect to the research, authorship, and/or 
      publication of this article.
EDAT- 2022/04/30 06:00
MHDA- 2022/05/03 06:00
PMCR- 2022/04/01
CRDT- 2022/04/29 01:53
PHST- 2022/04/29 01:53 [entrez]
PHST- 2022/04/30 06:00 [pubmed]
PHST- 2022/05/03 06:00 [medline]
PHST- 2022/04/01 00:00 [pmc-release]
AID - 10.1177_0897190020966207 [pii]
AID - 10.1177/0897190020966207 [doi]
PST - ppublish
SO  - J Pharm Pract. 2022 Apr;35(2):205-211. doi: 10.1177/0897190020966207. Epub 2020 
      Oct 14.