Your browser doesn't support javascript.
Assessment of anti-factor Xa activity in critically ill COVID-19 patients receiving three different anticoagulation regimens.
Hamad, Mohammed A; Dasuqi, Shereen A; Aleem, Aamer; Omran, Rasha A; AlQahtani, Rakan M; Alhammad, Fahad A; Alzeer, Abdulaziz H.
  • Hamad MA; Department of Critical Care, College of Medicine and King Khalid University Hospital, King Saud University Medical City, Riyadh, Saudi Arabia.
  • Dasuqi SA; Department of Acute Medicine, Arrowe Park Hospital, Wirral University Teaching Hospital NHS foundation Trust, United Kingdom.
  • Aleem A; Department of Pharmacy, King Khalid University Hospital, King Saudi University Medical City, Riyadh, Saudi Arabia.
  • Omran RA; Division of Hematology/Oncology, Department of Medicine, College of Medicine and King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.
  • AlQahtani RM; Department of Pharmaceutics and Pharmaceutical Technology, School of Pharmacy, The University of Jordan, Amman, Jordan.
  • Alhammad FA; Department of Critical Care, College of Medicine and King Khalid University Hospital, King Saud University Medical City, Riyadh, Saudi Arabia.
  • Alzeer AH; Department of Critical Care, College of Medicine and King Khalid University Hospital, King Saud University Medical City, Riyadh, Saudi Arabia.
SAGE Open Med ; 9: 20503121211049931, 2021.
Article in English | MEDLINE | ID: covidwho-1472333
ABSTRACT

INTRODUCTION:

Critically ill COVID-19 patients are at increased risk of thrombosis with an enhanced risk of bleeding. We aimed to explore the role of anti-factor Xa levels in optimizing the high-intensity anticoagulation's safety and efficacy and finding possible associations between D-dimer levels, cytokine storm markers, and COVID-19-induced coagulopathy or thrombophilia.

METHODS:

Retrospective cohort study conducted on 69 critically ill COVID-19 patients who received three regimens of higher intensity anticoagulation.

RESULTS:

Seventeen patients (24.6%) received high-dose enoxaparin prophylaxis, 29 patients (42%) received therapeutic doses of enoxaparin, and 23 patients (33.3%) were on therapeutic unfractionated heparin infusion. Fewer than one-third of the whole cohort (n = 22; 31.8%) achieved the target range of anti-factor Xa. The patients were divided into three subgroups based on anti-factor Xa target status within each anticoagulation regimen; when compared, the only association observed among them was for interleukin-6 levels, which were significantly higher in both the "above the expected range" and "below the expected range" groups compared with the "within the expected range" group (p = 0.009). Major bleeding episodes occurred in 14 (20.3%) patients and were non-significantly more frequent in the "below the expected anti-factor Xa range group" (p = 0.415). Seven patients (10.1%) developed thrombosis. The majority of patients had anti-factor Xa levels below the expected ranges (four patients, 57.1%).

CONCLUSION:

Conventional anti-factor Xa ranges may not be appropriate as a predictive surrogate for bleeding in critically ill COVID-19. The clinical decision to initiate therapeutic anticoagulation preemptively may be individualized according to thrombosis and bleeding risks. Cytokine storm markers, namely, interleukin-6, may play a role in COVID-19-induced coagulopathy or thrombophilia.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Prognostic study / Randomized controlled trials / Risk factors Language: English Journal: SAGE Open Med Year: 2021 Document Type: Article Affiliation country: 20503121211049931

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Prognostic study / Randomized controlled trials / Risk factors Language: English Journal: SAGE Open Med Year: 2021 Document Type: Article Affiliation country: 20503121211049931