Low molecular weight heparin is associated with better outcomes than unfractionated heparin for thromboprophylaxis in hospitalized COVID-19 patients: a meta-analysis.
Eur Heart J Qual Care Clin Outcomes
; 8(8): 909-918, 2022 Nov 17.
Article
in English
| MEDLINE | ID: covidwho-1973139
ABSTRACT
AIMS:
This study aimed to compare the outcomes of the administration of LMWH and UFH in hospitalized COVID-19 patients. METHODS ANDRESULTS:
We systematically searched several databases and included observational studies or clinical trials that compared the outcomes of the administration of LMWH and UFH in hospitalized COVID-19 patients. A total of nine studies comprising 9637 patients were included. Metanalysis showed that LMWH administration was associated with a lower in-hospital mortality and 28/30-day mortality compared with UFH administration {[relative risk (RR) 0.44; 95% confidence interval (95% CI) 0.32-0.61; I2 87.9%] and (RR 0.45; 95% CI 0.24-0.86; I2 78.4%), respectively}. Patient with LMWH had shorter duration of hospital and ICU length of stay compared with UFH {[weighted mean difference (WMD) -2.20; 95% CI -3.01 to -1.40; I20%] and (WMD -1.41; 95% CI -2.20 to -0.63; I2 0%), respectively}. The risk of ICU admission or mechanical ventilation was lower in patients who received LMWH than in those who received UFH (RR 0.67; 95% CI 0.55-0.81; I2 67.3%). However, there was no difference in the incidence of bleeding with LMWH compared with UFH (RR 0.27; 95% CI 0.07-1.01; I2 64.6%).CONCLUSION:
Our meta-analysis showed that administration of LMWH was associated with better outcomes compared with UFH in hospitalized COVID-19 patients. Prospective cohorts and RCTs are urgently needed to explore the definitive effect of LMWH to provide direct high-certainty evidence. PROSPERO registration number CRD42021271977.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Venous Thromboembolism
/
COVID-19
Type of study:
Cohort study
/
Observational study
/
Prognostic study
/
Reviews
Limits:
Humans
Language:
English
Journal:
Eur Heart J Qual Care Clin Outcomes
Year:
2022
Document Type:
Article
Affiliation country:
Ehjqcco
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