Beneficial Effects of Intermediate Dosage of Anticoagulation Treatment on the Prognosis of Hospitalized COVID-19 Patients: The ETHRA Study

Poulakou, Garyphallia; Dimakakos, Evangelos; Κόλλιας, Αναστάσιος; Kyriakoulis, Konstantinos G; Rapti, Vasiliki; Trontzas, Ioannis; Thanos, Charalampos; Abdel‐Rasoul, Mahmoud; Vantana, Theodora; Leontis, Konstantinos; Kakalou, Eleni; Argyraki, Katerina; Baraboutis, Ioannis G.; Michelakis, Evangelos D.; Giamarellos‐Bourboulis, Evangelos J.; Dimakou, Katerina; Tsoukalas, Georgios; Rapti, Ageliki; Syrigos, Konstantinos

doi:10.21873/invivo.12305

Cited by 23 publications

(25 citation statements)

References 39 publications

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“…Kollias, we, and others have suggested that the aggregate of these data indicate that the use of increased doses of heparins in severely ill patients may be too late to mitigate the thrombotic effects of COVID-19; starting earlier with higher doses of anticoagulants, as in the moderately-ill cohort of the mpRCT appears to be better. As pointed out by Kollias and colleagues, use of intermediate dose heparin in 95 patients admitted to the ward at their institution suggested improved outcomes (8), supporting the findings in the moderately-ill arm of the multiplatform trial.…”

supporting

confidence: 53%

When to use anticoagulation in COVID-19

Moll

Connors

2021

Thrombosis Research

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supporting

confidence: 53%

When to use anticoagulation in COVID-19

Moll

Connors

2021

Thrombosis Research

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“…At the time this cohort was recruited, several antiviral treatments, hydroxychloroquine plus azithromycin and tocilizumab were used, which have now been abandoned due to lack of efficacy. Moreover, although anticoagulation seems to play a role in COVID treatment [27,28], its use was not standardized and the protocols describing the indications and optimal doses varied throughout the study. We did not see a difference in prognosis according to the treatment received.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Implications of Chronic Heart Failure and Utility of NT-proBNP Levels in Heart Failure Patients with SARS-CoV-2 Infection

Belarte-Tornero

Valdivielso-Moré

Elcano

et al. 2021

JCM

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Background: The prevalence and prognostic value of chronic heart failure (CHF) in the setting of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection has seldom been studied. The aim of this study was to analyze the prevalence and prognosis of CHF in this setting. Methods: This single-center study included 829 consecutive patients with SARS-CoV-2 infection from February to April 2020. Patients with a previous history of CHF were matched 1:2 for age and sex. We analyze the prognostic value of pre-existing CHF. Prognostic implications of N terminal pro brain natriuretic peptide (NT-proBNP) levels on admission in the CHF cohort were explored. Results: A total of 129 patients (43 CHF and 86 non-CHF) where finally included. All-cause mortality was higher in CHF patients compared to non-CHF patients (51.2% vs. 29.1%, p = 0.014). CHF was independently associated with 30-day mortality (hazard ratio (HR) 2.3, confidence interval (CI) 95%: 1.26–2.4). Patients with CHF and high-sensitivity troponin T < 14 ng/L showed excellent prognosis. An NT-proBNP level > 2598 pg/mL on admission was associated with higher 30-day mortality in patients with CHF. Conclusions: All-cause mortality in CHF patients hospitalized due to SARS-CoV-2 infection was 51.2%. CHF was independently associated with all-cause mortality (HR 2.3, CI 95% 1.26–4.2). NT-proBNP levels could be used for stratification risk purposes to guide medical decisions if larger studies confirm this finding.

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“…Também, é indicada a utilização da enoxaparina 0,5 mg/kg 2x/dia, Heparina não fracionada 4000 a 10.000UI, subcutânea-3x/dia ou a administração de Dalteparina 5000UI subcutânea, 3x/dia, em casos de insuficiência renal (Canoglu, et al, 2020;Manolis, et al, 2021;billet, et al, 2020). Para a anticoagulação terapêutica, os estudos recomendam a utilização da Apixabana 5 mg ou Rivorababana 10 mg, HBPM 1mg/kg 2x/dia ou doses escalonadas de HBPM com enoxaparina, 0,5 mg/kg duas vezes por dia, embora pacientes com comorbidade precisem de ajustes da medicação a ser utilizada e/ou da dosagem, a citar os pacientes com insuficiência renal, nos quais são preferíveis, a heparina não fracionada (Billet, et al, 2020;Poulakou, et al, 2021;Canoglu, et al, 2020;Li, et al, 2020;Bozzani, et al, 2020).…”

Section: Discussão Gerenciamento Clínico Do Tromboembolismo Venoso E Pulmonarunclassified

Gerenciamento clínico de eventos tromboembólicos provenientes de complicações da COVID-19: revisão integrativa

Bispo

Machado

Paula

et al. 2021

RSD

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Objetivo: identificar de que forma ocorre o gerenciamento clínico de pacientes infectados por COVID-19 que apresentam tromboembolismo pulmonar e/ou tromboembolismo venoso. Método: Trata-se de uma revisão integrativa, realizada através da busca de artigos nas bases de dados BVS, LILACS, MEDLINE, CINAHL E SCOPUS, com delimitação temporal de novembro de 2019 a março de 2021. Resultados: Foram incluídos 24 artigos. O diagnóstico ocorre através do D-dímero e fibrinogênio. Para a terapia medicamentosa, administra-se a Heparina de baixo peso molecular (HBPM), sendo 30 mg/12h em 12h para a anticogulação profilática, doses escalonadas de HBPM com enoxaparina, 0,5 mg/kg duas vezes por dia para a anticoagulação terapêutica e rivoraxabana 10mg/dia para a anticoagulação pós alta. Conclusão: O gerenciamento clínico de TEP e TEV ocorre através do aumento do D-dímero ou do fibrinogênio, com o TEP confirmado através da angiografia pulmonar. Para a anticoagulação, utiliza-se a HBPM, maiormente.

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Beneficial Effects of Intermediate Dosage of Anticoagulation Treatment on the Prognosis of Hospitalized COVID-19 Patients: The ETHRA Study

Cited by 23 publications

References 39 publications

When to use anticoagulation in COVID-19

When to use anticoagulation in COVID-19

Prognostic Implications of Chronic Heart Failure and Utility of NT-proBNP Levels in Heart Failure Patients with SARS-CoV-2 Infection

Gerenciamento clínico de eventos tromboembólicos provenientes de complicações da COVID-19: revisão integrativa

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