PMID- 38355124
OWN - NLM
STAT- Publisher
LR  - 20240214
IS  - 1880-3873 (Electronic)
IS  - 1340-3478 (Linking)
DP  - 2024 Feb 14
TI  - Unfractionated Heparin Safety in COVID-19: Incidence and Risks of Bleeding 
      Complications in Japan.
LID - 10.5551/jat.64448 [doi]
AB  - AIM: Several studies have shown the efficacy and safety of low-molecular-weight 
      heparin use in coronavirus disease 2019 (COVID-19), but that of unfractionated 
      heparin (UFH) has not been investigated. We investigated the prevalence of 
      bleeding complications during UFH administration, its impact on mortality, and 
      the risk factors of bleeding outcomes associated with UFH. METHODS: This 
      retrospective cohort study was conducted at a single-center tertiary care 
      hospital, including hospitalized patients with COVID-19. The primary outcomes 
      were measured as the prevalence of bleeding complications during hospitalization, 
      and the secondary outcomes were thromboembolic events and 60-day mortality rates. 
      Logistic regression analysis and propensity score matching were used to assess 
      risk factors for bleeding complications and their impact on mortality. RESULTS: 
      Among 1035 included patients, 516 patients were treated with UFH. Twelve (2.3%) 
      patients in the UFH group experienced major bleeding. The prevalence of major 
      bleeding in patients treated with therapeutic-dose UFH was 9.2%. Logistic 
      regression analysis showed that age >/= 60 years (adjusted odds ratio [aOR], 3.89; 
      95% confidence interval [CI], 1.01-15.0; P＜.05) and COVID-19 severity (aOR, 35.9; 
      95% CI, 4.57-282; P ＜.05) were associated with major bleeding complications. 
      After propensity score matching, 11 major and 11 non-major bleeding cases 
      (including minor bleeding) were matched. The 60-day cumulative mortality rate 
      between the two groups did not differ significantly (P=.13, log-rank test). 
      CONCLUSIONS: The incidence of major bleeding in COVID-19 patients using 
      therapeutic-dose UFH was relatively high. Critical COVID-19 and older age were 
      risk factors for bleeding complications.
FAU - Sato, Lubna
AU  - Sato L
AD  - Disease Control and Prevention Center, National Center for Global Health and 
      Medicine.
AD  - Department of Emergency and Critical Care Medicine, Fukushima Medical University.
FAU - Iwamoto, Noriko
AU  - Iwamoto N
AD  - Disease Control and Prevention Center, National Center for Global Health and 
      Medicine.
AD  - AMR Clinical Reference Center, National Center for Global Health and Medicine.
FAU - Kakumoto, Yuko
AU  - Kakumoto Y
AD  - Disease Control and Prevention Center, National Center for Global Health and 
      Medicine.
FAU - Tsuzuki, Shinya
AU  - Tsuzuki S
AD  - Disease Control and Prevention Center, National Center for Global Health and 
      Medicine.
AD  - AMR Clinical Reference Center, National Center for Global Health and Medicine.
FAU - Togano, Tomiteru
AU  - Togano T
AD  - Department of Hematology, National Center for Global Health and Medicine.
FAU - Ishikane, Masahiro
AU  - Ishikane M
AD  - Disease Control and Prevention Center, National Center for Global Health and 
      Medicine.
AD  - AMR Clinical Reference Center, National Center for Global Health and Medicine.
FAU - Okumura, Nobumasa
AU  - Okumura N
AD  - Disease Control and Prevention Center, National Center for Global Health and 
      Medicine.
FAU - Yamada, Gen
AU  - Yamada G
AD  - Disease Control and Prevention Center, National Center for Global Health and 
      Medicine.
FAU - Inada, Makoto
AU  - Inada M
AD  - Disease Control and Prevention Center, National Center for Global Health and 
      Medicine.
FAU - Suzuki, Tetsuya
AU  - Suzuki T
AD  - Disease Control and Prevention Center, National Center for Global Health and 
      Medicine.
FAU - Hojo, Masayuki
AU  - Hojo M
AD  - Department of Respiratory Medicine, National Center for Global Health and 
      Medicine.
FAU - Takasaki, Jin
AU  - Takasaki J
AD  - Department of Respiratory Medicine, National Center for Global Health and 
      Medicine.
FAU - Sasaki, Ryo
AU  - Sasaki R
AD  - Department of Emergency Medicine and Critical Care, National Center for Global 
      Health and Medicine.
FAU - Kimura, Akio
AU  - Kimura A
AD  - Department of Emergency Medicine and Critical Care, National Center for Global 
      Health and Medicine.
FAU - Teruya, Katsuji
AU  - Teruya K
AD  - AIDS Clinical Center, National Center for Global Health and Medicine.
FAU - Okamoto, Tatsuya
AU  - Okamoto T
AD  - Department of Intensive Care Medicine, National Center for Global Health and 
      Medicine.
FAU - Hayakawa, Kayoko
AU  - Hayakawa K
AD  - Disease Control and Prevention Center, National Center for Global Health and 
      Medicine.
AD  - AMR Clinical Reference Center, National Center for Global Health and Medicine.
FAU - Hara, Hisao
AU  - Hara H
AD  - Department of Cardiology, National Center for Global Health and Medicine.
FAU - Iseki, Ken
AU  - Iseki K
AD  - Department of Emergency and Critical Care Medicine, Fukushima Medical University.
FAU - Ohmagari, Norio
AU  - Ohmagari N
AD  - Disease Control and Prevention Center, National Center for Global Health and 
      Medicine.
AD  - AMR Clinical Reference Center, National Center for Global Health and Medicine.
LA  - eng
PT  - Journal Article
DEP - 20240214
PL  - Japan
TA  - J Atheroscler Thromb
JT  - Journal of atherosclerosis and thrombosis
JID - 9506298
SB  - IM
OTO - NOTNLM
OT  - Bleeding complication
OT  - Bleeding risk factors
OT  - COVID-19
OT  - Unfractionated heparin
OT  - Venous thromboembolism
EDAT- 2024/02/15 00:42
MHDA- 2024/02/15 00:42
CRDT- 2024/02/14 19:53
PHST- 2024/02/15 00:42 [medline]
PHST- 2024/02/15 00:42 [pubmed]
PHST- 2024/02/14 19:53 [entrez]
AID - 10.5551/jat.64448 [doi]
PST - aheadofprint
SO  - J Atheroscler Thromb. 2024 Feb 14. doi: 10.5551/jat.64448.