PMID- 35942505
OWN - NLM
STAT- MEDLINE
DCOM- 20230312
LR  - 20240326
IS  - 1542-6270 (Electronic)
IS  - 1060-0280 (Print)
IS  - 1060-0280 (Linking)
VI  - 57
IP  - 4
DP  - 2023 Apr
TI  - Effectiveness and Safety of Enoxaparin Versus Unfractionated Heparin as 
      Thromboprophylaxis in Hospitalized COVID-19 Patients: Real-World Evidence.
PG  - 361-374
LID - 10.1177/10600280221115299 [doi]
AB  - BACKGROUND: Coronavirus 2019 (COVID-19) patients are at risk of thrombosis. 
      Literature that compares the effectiveness of enoxaparin to unfractionated 
      heparin (UFH) in COVID-19 patients is scarce. OBJECTIVE: We aimed to evaluate the 
      effectiveness and safety of enoxaparin compared with UFH when used at their 
      standard/intermediate dosing in COVID-19 patients. METHODS: This was a 
      retrospective study conducted at a large COVID-19 center located in Eastern 
      Province, Saudi Arabia. Confirmed COVID-19 cases (>/=18 years old) admitted between 
      January and December 2020 were randomly screened for inclusion. Exclusion 
      criteria were patients receiving therapeutic anticoagulation, on chronic 
      anticoagulation, had active bleeding, a platelet count <25 x 10(9)/L, or an 
      incomplete electronic file. The primary endpoint was the occurrence of any 
      thrombotic event (pulmonary embolism, deep venous thrombosis, stroke, or 
      myocardial infarction) or mortality. Secondary endpoints were major or minor 
      bleeding. We applied inverse propensity score weighting (IPTW) with survival 
      analysis to analyze the primary endpoint. Logistic regression was used for the 
      secondary endpoint. RESULTS: A total of 980 patients were included (enoxaparin, n 
      = 470 and UFH, n = 510) with a mean age (+/-SD) of 47.7 (+/- 12.3) for the enoxaparin 
      arm and 52 (+/-13.9) for the UFH arm. There was a statistically significant 
      difference in the primary endpoint with an adjusted hazard ratio (aHR) of 0.46 
      (95%CI: 0.22 to 0.96, P = 0.039) in favor of the enoxaparin arm. There was no 
      statistically significant difference in major or minor bleeding rates between the 
      two arms. CONCLUSION AND RELEVANCE: When compared with UFH, enoxaparin was 
      associated with a significant reduction in thrombotic events or mortality among 
      COVID-19 patients. The results need confirmation from randomized controlled 
      trials.
FAU - AlLehaibi, Lina H
AU  - AlLehaibi LH
AD  - Eastern Health Cluster, Dammam Medical Complex, Dammam, Saudi Arabia.
FAU - Alomar, Mukhtar
AU  - Alomar M
AD  - Eastern Health Cluster, Dammam Medical Complex, Dammam, Saudi Arabia.
FAU - Almulhim, Abdulaziz
AU  - Almulhim A
AD  - Department of Pharmacy Practice, College of Clinical Pharmacy, King Faisal 
      University, Al-Ahsa, Saudi Arabia.
FAU - Al-Makki, Sarah
AU  - Al-Makki S
AD  - Eastern Health Cluster, Dammam Medical Complex, Dammam, Saudi Arabia.
FAU - Alrwaili, Nazar R
AU  - Alrwaili NR
AD  - Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman 
      Bin Faisal University, Dammam, Saudi Arabia.
FAU - Al-Bassam, Shahad
AU  - Al-Bassam S
AD  - Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman 
      Bin Faisal University, Dammam, Saudi Arabia.
FAU - Alsultan, Semat
AU  - Alsultan S
AD  - Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman 
      Bin Faisal University, Dammam, Saudi Arabia.
FAU - Al Saeed, Jenan
AU  - Al Saeed J
AD  - Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman 
      Bin Faisal University, Dammam, Saudi Arabia.
FAU - Alsheef, Mohammad
AU  - Alsheef M
AD  - Department of Medicine, King Fahad Medical City, Riyadh, Saudi Arabia.
FAU - Abraham, Ivo
AU  - Abraham I
AUID- ORCID: 0000-0003-0490-4421
AD  - Center for Health Outcomes & PharmacoEconomic Research, University of Arizona, 
      Tucson, AZ, USA.
FAU - Alamer, Ahmad
AU  - Alamer A
AUID- ORCID: 0000-0002-2091-1376
AD  - Center for Health Outcomes & PharmacoEconomic Research, University of Arizona, 
      Tucson, AZ, USA.
AD  - Department of Clinical Pharmacy, Prince Sattam Bin Abdulaziz University, Alkharj, 
      Saudi Arabia.
LA  - eng
PT  - Comparative Study
PT  - Evaluation Study
PT  - Journal Article
DEP - 20220808
PL  - United States
TA  - Ann Pharmacother
JT  - The Annals of pharmacotherapy
JID - 9203131
RN  - 0 (Anticoagulants)
RN  - 0 (Enoxaparin)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Humans
MH  - Anticoagulants/adverse effects
MH  - *COVID-19
MH  - Enoxaparin/adverse effects
MH  - Heparin/adverse effects
MH  - Retrospective Studies
MH  - Treatment Outcome
MH  - *Venous Thromboembolism
MH  - Adult
MH  - Middle Aged
MH  - Aged
PMC - PMC9996167
OTO - NOTNLM
OT  - COVID-19
OT  - effectiveness
OT  - enoxaparin
OT  - heparin
OT  - mortality
OT  - real-world
OT  - thrombosis
OT  - trial
COIS- The authors declared no potential conflicts of interest with respect to the 
      research, authorship, and/or publication of this article.
EDAT- 2022/08/10 06:00
MHDA- 2023/03/10 06:00
PMCR- 2022/08/08
CRDT- 2022/08/09 02:13
PHST- 2022/08/10 06:00 [pubmed]
PHST- 2023/03/10 06:00 [medline]
PHST- 2022/08/09 02:13 [entrez]
PHST- 2022/08/08 00:00 [pmc-release]
AID - 10.1177_10600280221115299 [pii]
AID - 10.1177/10600280221115299 [doi]
PST - ppublish
SO  - Ann Pharmacother. 2023 Apr;57(4):361-374. doi: 10.1177/10600280221115299. Epub 
      2022 Aug 8.