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Low molecular weight heparin reduces arterial blood lactic acid content and increases estimated glomerular filtration rate in patients with moderate Covid-19 pneumonia.
Ma, Li; Zeng, Yigang; Zhao, Bing; Xu, Lili; Li, Jian; Zhu, Tongyu; Mao, Enqiang.
  • Ma L; Emergency Department of Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200025, China.
  • Zeng Y; Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China.
  • Zhao B; Emergency Department of Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200025, China.
  • Xu L; Emergency Department of Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200025, China.
  • Li J; Clinical Research Center in Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200025, China.
  • Zhu T; Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China.
  • Mao E; Emergency Department of Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200025, China.
Chin Med J (Engl) ; 135(6): 691-696, 2022 Mar 20.
Article in English | MEDLINE | ID: covidwho-1806655
ABSTRACT

BACKGROUND:

Coronavirus disease 2019 (Covid-19) remains a serious health threat worldwide. We aimed to investigate whether low molecular weight heparin (LMWH) can promote organ function recovery in moderate Covid-19 pneumonia patients.

METHODS:

We initiated an LMWH protocol in Covid-19 patients with increased D-dimer, body mass index >30 kg/m2 or a history of diabetes from January 18, 2020 at Shanghai Public Health Clinical Center. In this retrospective study, we assigned moderate Covid- 19 pneumonia patients admitted between January 18th and April 18, 2020 receiving the LMWH protocol to the LMWH group. Moderate patients who met the inclusion criteria but did not receive LMWH protocol were included in the control group by 12 propensity score matching. General clinical information, indicators for renal function, arterial blood gas analyses, arterial blood lactic acid content (mmol/L), and coagulation indexes at 0 day, 3 days, 7 days, and 11 days after admission were recorded and compared between the two groups.

RESULTS:

There were 41 patients in the LMWH group and 82 patients in the control group. General information in both groups were similar. Compared to the control group, the arterial blood lactic acid content (mmol/L) at day 11 (1.3 [1.1, 1.7] vs. 1.2 [0.9, 1.3], P = 0.016) was reduced in the LMWH group. The estimated glomerular filtration rate (eGFR) in the LMWH group was higher than that in the control group at day 7 (108.54 [89.11, 128.17] vs. 116.85 [103.39, 133.47], P = 0.039) and day 11 (113.74 [94.49, 126.34] vs. 128.31 [112.75, 144, 12], P  = 0.003). The serum creatinine levels (Scr) in the LMWH group were lower than that in the control group at day 7 (62.13 [51.47, 77.64] vs. 55.49 [49.50, 65.75], P = 0.038) and day 11 (63.35 [50.17, 75.73] vs. 51.62 [44.62, 61.24], P = 0.005).

CONCLUSIONS:

LMWH treatment can reduce arterial blood lactic acid levels and improve eGFR in moderate Covid-19 pneumonia patients. Randomized controlled trials are warranted to further investigate this issue. TRIAL REGISTRATION ChiCTR.org.cn, ChiCTR2000034796.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Heparin, Low-Molecular-Weight / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Country/Region as subject: Asia Language: English Journal: Chin Med J (Engl) Year: 2022 Document Type: Article Affiliation country: CM9.0000000000001923

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Heparin, Low-Molecular-Weight / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Country/Region as subject: Asia Language: English Journal: Chin Med J (Engl) Year: 2022 Document Type: Article Affiliation country: CM9.0000000000001923