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ORIGINAL ARTICLE
Year : 2021  |  Volume : 4  |  Issue : 2  |  Page : 40-45

Clinical study of anticoagulant therapy in patients with severe coronavirus disease: A single-center retrospective analysis


1 Department of Vascular Surgery, Tongji Medical College, Union Hospital, Huazhong University of Science and Technology, Wuhan, China
2 Department of Thoracic Surgery, Tongji Medical College, Union Hospital, Huazhong University of Science and Technology, Wuhan, China
3 Department of Pediatrics, Tongji Medical College, Union Hospital, Huazhong University of Science and Technology, Wuhan, China

Correspondence Address:
Dr. Chao Yang
Department of Vascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan
China
Dr. Qin Li
Department of Vascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan
China
Dr. Yi-Qing Li
Department of Vascular Surgery, Tongji Medical College, Union Hospital, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/VIT-D-21-00010

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OBJECTIVE: The prognosis of COVID-19 is related to thrombotic events. This study investigated prognostic risk factors, anticoagulant therapy effects, and potential instruction of treatment or prognostic with D-dimer in patients with severe COVID-19 receiving anticoagulant therapy. MATERIALS AND METHODS: We undertook a retrospective study of 87 severe COVID-19 patients who had prophylactic low-molecular-weight heparin (LMWH) therapy. Patients were divided into two groups according to whether high-flow oxygen therapy was required during hospitalization: Better and poor prognoses. RESULTS: Multivariate logistic regression using risk factors measured before LMWH therapy revealed that older age (P < 0.035) and higher C-reactive protein (CRP) levels (P = 0.002) had a prognostic value. Anticoagulant therapy yielded significant changes in CRP levels (P < 0.001), white blood cell counts (P = 0.001), neutrophil counts (P < 0.001), neutrophil/lymphocyte ratios (P < 0.001), eosinophil counts (P = 0.031), and D-dimer levels (P < 0.001) in the better prognosis group and in D-dimer levels (P = 0.043) only in the poor prognosis group. Prognoses at different D-dimer levels at anticoagulant therapy initiation varied. Among 47 and 40 patients with D-dimer levels ≤4 and >4 μg/ml fibrin equivalent unit (FEU), 33 (70.6%) and 18 (45%) had better prognosis (P = 0.012), respectively. CONCLUSION: Anticoagulant therapy reduced inflammation in patients with better prognosis; conversely, minimal effect was observed in those with poor prognosis. During LMWH therapy patients with D-dimer levels, patients receiving anticoagulant therapy at D-dimer levels ≤4 μg/ml FEU had a better prognosis than those at >4 μg/ml FEU.


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