Heparin and SARS-CoV-2: Multiple Pathophysiological Links

Micco, Pierpaolo Di; Imbalzano, Egidio; Russo, Vincenzo; Attena, Emilio; Mandaliti, Vincenzo; Orlando, Luana; Lombardi, Maurizio; Micco, Gianluca Di; Camporese, Giuseppe; Annunziata, Saverio; Piccinocchi, Gaetano; Pacelli, Walter; Guercio, Michele Del

doi:10.3390/v13122486

Cited by 12 publications

(9 citation statements)

References 61 publications

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“…Mechanical thromboprophylaxis is advised at a minimum [26,27]. Enoxaparin has the potential to bind certain viruses as they pass through the extracellular matrix of the respiratory tract [38]. This may provide additional benefit.…”

Section: Discussionmentioning

confidence: 99%

The Incidence of Venous Thromboembolism in Critically Ill Patients with SARS-CoV-2 Infection Compared with Critically Ill Influenza and Community-Acquired Pneumonia Patients: A Retrospective Chart Review

et al. 2022

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The rate of venous thromboembolism in COVID-19 patients has been reported to be 30% (deep vein thrombosis 20% and pulmonary embolism 18%). This has been shown to be higher in COVID-19 patients admitted to the ICU. Prophylactic anticoagulation may be sufficient at ward level, but not in intensive care. A retrospective chart review was undertaken in a large university hospital. The review included 276 patients from COVID-19 Wave 1, COVID-19 Wave 2, influenza, and community-acquired pneumonia groups. The timeframe included patients admitted between 23 February 2014 and 12 May 2021. Clinical characteristics, outcomes, blood results, rates of venous thromboembolism, and anticoagulation status were recorded. The incidence of venous thromboembolism in COVID-19 Wave 1, COVID-19 Wave 2, influenza, and community-acquired pneumonia was 10.91%, 13.69%, 13.33%, and 6.81%, respectively (p = 0.481). The incidence of pulmonary embolism was 7.27%, 10.95%, 3.33%, and 5.68%, respectively (p = 0.350). The incidence of deep vein thrombosis was 5.45%, 5.48%, 10.00%, and 1.14%, respectively (p = 0.117). Although most patients were prophylactically anticoagulated, venous thromboembolism still occurred. Venous thromboembolism remains an important differential to consider in critically ill COVID-19 patients. The current literature does not advise therapeutic anticoagulation for thromboprophylaxis in the ICU.

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Section: Discussionmentioning

confidence: 99%

The Incidence of Venous Thromboembolism in Critically Ill Patients with SARS-CoV-2 Infection Compared with Critically Ill Influenza and Community-Acquired Pneumonia Patients: A Retrospective Chart Review

et al. 2022

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“…Heparin is extremely significant in the treatment of COVID19 patients due to its properties, mainly its similarity to heparan sulphate, which appears in a respiratory tract, its interactions with SARS-CoV-2 S protein, leading to viral adhesion inhibiting to the cell membrane [ 82 ], and its anti-inflammatory effects. Thanks to these properties, heparin may not only show its therapeutic effect as the anticoagulant, but also its protective role in acute pancreatitis or respiratory inflammations [ 83 , 84 , 85 ].…”

Section: Pancreatitis In Covid-19mentioning

confidence: 99%

Consequences of COVID-19 for the Pancreas

Abramczyk

Nowaczyński

Słomczyński

et al. 2022

IJMS

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Although coronavirus disease 2019 (COVID-19)-related major health consequences involve the lungs, a growing body of evidence indicates that COVID-19 is not inert to the pancreas either. This review presents a summary of the molecular mechanisms involved in the development of pancreatic dysfunction during the course of COVID-19, the comparison of the effects of non-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on pancreatic function, and a summary of how drugs used in COVID-19 treatment may affect this organ. It appears that diabetes is not only a condition that predisposes a patient to suffer from more severe COVID-19, but it may also develop as a consequence of infection with this virus. Some SARS-CoV-2 inpatients experience acute pancreatitis due to direct infection of the tissue with the virus or due to systemic multiple organ dysfunction syndrome (MODS) accompanied by elevated levels of amylase and lipase. There are also reports that reveal a relationship between the development and treatment of pancreatic cancer and SARS-CoV-2 infection. It has been postulated that evaluation of pancreatic function should be increased in post-COVID-19 patients, both adults and children.

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“…On top of its antithrombotic action, heparin exerts an anti-inflammatory effect, a protective action on endothelial function [9], and a specific antiviral action in the extracellular matrix of tissues [10]. A short retrospective cohort analysis showed that the administration of low-molecular-weight heparin (LMWH) resulted in an increased number of lymphocytes and lower interleukin-6 (IL-6) levels compared to control patients, demonstrating an improvement in coagulation profiles and the restoration of immune functions.…”

Section: Introductionmentioning

confidence: 99%

The Comparison of Therapeutic With Prophylactic Anticoagulation on Mortality, Risk of Bleeding, and Thromboembolism in Hospitalized Patients With COVID-19: A Systematic Review

Kham¹,

Shahid²,

Naik³

et al. 2022

Cureus

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Thromboembolism is one of the most severe manifestations of coronavirus disease 2019 . Thrombotic complications have been reported even with the administration of thromboprophylaxis. This has led many experts to have variable opinions on the most effective prophylactic strategy and to anticipate the discovery of the ideal dosing of anticoagulation to reduce thromboembolic events and related mortality. We performed a systematic review to evaluate whether therapeutic-dose anticoagulation is superior to prophylactic-dose anticoagulation by comparing mortality rates, bleeding risks, and rates of thromboembolism. We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to create our systematic review. Twenty-two records were collected from PubMed, PubMed Central (PMC), and Medical Literature Analysis and Retrieval System Online (MEDLINE), after which they undertook quality appraisals. A total of 124 studies were analyzed in six systematic reviews and meta-analyses, one pooled analysis, two multicenter retrospective cohort studies, one observational study, one retrospective chart review, one evidence-based protocol, and four narrative reviews.

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Heparin and SARS-CoV-2: Multiple Pathophysiological Links

Cited by 12 publications

References 61 publications

The Incidence of Venous Thromboembolism in Critically Ill Patients with SARS-CoV-2 Infection Compared with Critically Ill Influenza and Community-Acquired Pneumonia Patients: A Retrospective Chart Review

The Incidence of Venous Thromboembolism in Critically Ill Patients with SARS-CoV-2 Infection Compared with Critically Ill Influenza and Community-Acquired Pneumonia Patients: A Retrospective Chart Review

Consequences of COVID-19 for the Pancreas

The Comparison of Therapeutic With Prophylactic Anticoagulation on Mortality, Risk of Bleeding, and Thromboembolism in Hospitalized Patients With COVID-19: A Systematic Review

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