ABSTRACT
Objective: Current guidelines recommend thromboprophylaxis with low molecular weight heparin (LMWH) in patients with coronavirus disease-2019 (COVID-19). However, there is no current consensus on the routine application of thromboprophylaxis. This study aimed to evaluate the effect of routine application of LMWH on clinical outcomes including mortality and the need for intensive care unit (ICU) admission in hospitalized COVID-19 patients. Material and Methods: All confirmed patients with COVID-19 hospitalized in COVID-19 dedicated wards, from March 15 to May 15, 2020, were included in this retrospective cohort study. Two groups of patients were established, according to the non-routine and routine application of LMWH with therapeutic, weight-based, anticoagulation dosing. Clinical, laboratory and treatment data were collected, analyzed, and compared between the two groups. The initial and extreme values of the laboratory tests were used for analysis. A logistic regression model was developed to assess the factors related to in-hospital adverse outcomes. Results: A total of 1,511 patients (797 men, median age 59.0 years) were retrospectively analyzed [group non-routine LMWH (n=828);group routine LMWH (n=683)]. Multivariate logistic regression analysis showed routine use of LMWH, favipiravir administration, extreme values of white blood cell count, neutrophil lymphocyte ratio, and troponin I as factors independently associated with in-hospital adverse outcomes (odds ratio=0.25, 95% confidence interval: 0.83-0.91;p<0.001 for routine use of LMWH). Conclusion: In hospitalized COVID-19 patients routine treatment with therapeutic LMWH dosage was associated with a 75% decrease in mortality and need for ICU admission compared with the non-routine administration when adjusted for other variables in this study. © 2022, Turkiye Klinikleri. All rights reserved.