TY - JOUR
T1 - Prophylactic heparin and risk of orotracheal intubation or death in patients with mild or moderate COVID-19 pneumonia
AU - Vergori, Alessandra
AU - Lorenzini, Patrizia
AU - Gualano, Gina
AU - Nicastri, Emanuele
AU - The ReCOVeRI Study Group
AU - Iacomi, Fabio
AU - Marchioni, Luisa
AU - Campioni, Paolo
AU - Schininà, Vincenzo
AU - Cicalini, Stefania
AU - Agrati, Chiara
AU - Capobianchi, Maria Rosaria
AU - Girardi, Enrico
AU - Ippolito, Giuseppe
AU - Vaia, Francesco
AU - Petrosillo, Nicola
AU - Antinori, Andrea
AU - Taglietti, Fabrizio
AU - Abdeddaim, Amina
AU - Albarello, Fabrizio
AU - Amendola, Alessandra
AU - Antonini, Mario
AU - Bartoli, Tommaso Ascoli
AU - Baldini, Francesco
AU - Barbaro, Raffaella
AU - Bartolini, Barbara
AU - Bellagamba, Rita
AU - Bevilacqua, Nazario
AU - Biava, Gianluigi
AU - Bibas, Michele
AU - Bordi, Licia
AU - Bordoni, Veronica
AU - Boumis, Evangelo
AU - Busso, Donatella
AU - Camici, Marta
AU - Capobianchi, Maria Rosaria
AU - Capone, Alessandro
AU - Caraffa, Emanuela
AU - Caravella, Ilaria
AU - Carletti, Fabrizio
AU - Castilletti, Concetta
AU - Cerilli, Stefano
AU - Chiappini, Roberta
AU - Chinello, Pierangelo
AU - Ciaralli, Carmine
AU - Cimaglia, Claudia
AU - Colavita, Francesca
AU - Corpolongo, Angela
AU - Cristofaro, Massimo
AU - Curiale, Salvatore
AU - Dantimi, Cristina
AU - De Angelis, Alessia
AU - De Angelis, Giada
AU - De Zottis, Federico
AU - Di Bari, Virginia
AU - Di Lorenzo, Rachele
AU - Di Stefano, Federica
AU - Faraglia, Francesca
AU - Ferraro, Federica
AU - Frustaci, Andrea
AU - Fusetti, Matteo
AU - Fusto, Marisa
AU - Galati, Vincenzo
AU - Gagliardini, Roberta
AU - Gallì, Paola
AU - Garotto, Gabriele
AU - Tekle, Saba Gebremeskel
AU - Giancola, Maria Letizia
AU - Giansante, Filippo
AU - Giombini, Emanuela
AU - Granata, Guido
AU - Greci, Maria Cristina
AU - Grilli, Elisabetta
AU - Grisetti, Susanna
AU - Iannicelli, Giuseppina
AU - Lalle, Eleonora
AU - Lanini, Simone
AU - Lapa, Daniele
AU - Lepore, Luciana
AU - Libertone, Raffaella
AU - Lionetti, Raffaella
AU - Liuzzi, Giuseppina
AU - Loiacono, Laura
AU - Macchione, Manuela
AU - Maffongelli, Gaetano
AU - Marani, Alessandra
AU - Mariano, Andrea
AU - Marini, Maria Cristina
AU - Maritti, Micaela
AU - Mastrobattista, Annelisa
AU - Mastrorosa, Ilaria
AU - Matusali, Giulia
AU - Mazzotta, Valentina
AU - Mencarini, Paola
AU - Meschi, Silvia
AU - Messina, Francesco
AU - Mondi, Annalisa
AU - Montalbano, Marzia
AU - Montaldo, Chiara
AU - Mosti, Silvia
AU - Murachelli, Silvia
AU - Musso, Maria
AU - Navarra, Assunta
AU - Noto, Pasquale
AU - Oliva, Alessandra
AU - Ottou, Sandrine
AU - Palazzolo, Claudia
AU - Palmieri, Fabrizio
AU - Pareo, Carlo
AU - Petrecchia, Antonella
AU - Petrone, Ada
AU - Pianura, Elisa
AU - Pinnetti, Carmela
AU - Piselli, Pierluca
AU - Pittalis, Silvia
AU - Puro, Vincenzo
AU - Ramazzini, Paolo Migliorisi
AU - Rianda, Alessia
AU - Rosati, Silvia
AU - Rueca, Martina
AU - Sacchi, Alessandra
AU - Sampaolesi, Alessandro
AU - Santagata, Carmen
AU - Scarabello, Alessandra
AU - Scognamiglio, Paola
AU - Scorzolini, Laura
AU - Stazi, Giulia
AU - Taibi, Chiara
AU - Tonnarini, Roberto
AU - Topino, Simone
AU - Vairo, Francesco
AU - Valli, Maria Beatrice
AU - Vincenzi, Laura
AU - Visco-Comandini, Ubaldo
AU - Vita, Serena
AU - Vittozzi, Pietro
AU - Zaccarelli, Mauro
N1 - Funding Information:
The corresponding author is responsible for submitting a competing interests statement on behalf of all authors of the paper. Alessandra Vergori, Patrizia Lorenzini, Alessandro Cozzi lepri, Davide Roberto Donno, Emanuele Nicastri, Gina Gualano, Fabio Iacomi, Luisa Marchioni, Paolo Campioni, Vincenzo Schininà, Stefania Cicalini, Chiara Agrati, Maria Rosaria Capobianchi, Enrico Girardi, Giuseppe Ippolito, Francesco Vaia, Nicola Petrosillo, Andrea Antinori and Fabrizio Taglietti have no competing interests that might be perceived to influence the results and/or discussion reported in this paper. Outside of this submitted work: Alessandra Vergori received institutional grant from Gilead Sciences, personal fees and travel grant from Janssen, personal fee from MSD; Andrea Antinori has served as a paid consultant to Gilead Sciences, Janssen-Cilag, Merck and ViiV Healthcare and received research institutional grants from Gilead Sciences, Janssen-Cilag and ViiV Healthcare; Enrico Girardi received institutional grants for Gilead Sciences and Mylan, personal fees from Gilead Sciences and ViiV; Nicola Petrosillo received personal fees from Shionogi Ltd, MSD, Becton &Dickinson, Pfizer and Cepheid. The other co-authors declare no conflicts of interests outside the submitted work.
Funding Information:
This work was supported by Line one—Ricerca Corrente ‘Infezioni Emergenti e Riemergenti’ and by Progetto COVID-2020-12371675 both funded by Italian Ministry of Health.
Publisher Copyright:
© 2021, The Author(s).
PY - 2021/12
Y1 - 2021/12
N2 - Prophylactic low molecular weight heparin (pLMWH) is currently recommended in COVID-19 to reduce the risk of coagulopathy. The aim of this study was to evaluate whether the antinflammatory effects of pLMWH could translate in lower rate of clinical progression in patients with COVID-19 pneumonia. Patients admitted to a COVID-hospital in Rome with SARS-CoV-2 infection and mild/moderate pneumonia were retrospectively evaluated. The primary endpoint was the time from hospital admission to orotracheal intubation/death (OTI/death). A total of 449 patients were included: 39% female, median age 63 (IQR, 50–77) years. The estimated probability of OTI/death for patients receiving pLMWH was: 9.5% (95% CI 3.2–26.4) by day 20 in those not receiving pLMWH vs. 10.4% (6.7–15.9) in those exposed to pLMWH; p-value = 0.144. This risk associated with the use of pLMWH appeared to vary by PaO2/FiO2 ratio: aHR 1.40 (95% CI 0.51–3.79) for patients with an admission PaO2/FiO2 ≤ 300 mmHg and 0.27 (0.03–2.18) for those with PaO2/FiO2 > 300 mmHg; p-value at interaction test 0.16. pLMWH does not seem to reduce the risk of OTI/death mild/moderate COVID-19 pneumonia, especially when respiratory function had already significantly deteriorated. Data from clinical trials comparing the effect of prophylactic vs. therapeutic dosage of LMWH at various stages of COVID-19 disease are needed.
AB - Prophylactic low molecular weight heparin (pLMWH) is currently recommended in COVID-19 to reduce the risk of coagulopathy. The aim of this study was to evaluate whether the antinflammatory effects of pLMWH could translate in lower rate of clinical progression in patients with COVID-19 pneumonia. Patients admitted to a COVID-hospital in Rome with SARS-CoV-2 infection and mild/moderate pneumonia were retrospectively evaluated. The primary endpoint was the time from hospital admission to orotracheal intubation/death (OTI/death). A total of 449 patients were included: 39% female, median age 63 (IQR, 50–77) years. The estimated probability of OTI/death for patients receiving pLMWH was: 9.5% (95% CI 3.2–26.4) by day 20 in those not receiving pLMWH vs. 10.4% (6.7–15.9) in those exposed to pLMWH; p-value = 0.144. This risk associated with the use of pLMWH appeared to vary by PaO2/FiO2 ratio: aHR 1.40 (95% CI 0.51–3.79) for patients with an admission PaO2/FiO2 ≤ 300 mmHg and 0.27 (0.03–2.18) for those with PaO2/FiO2 > 300 mmHg; p-value at interaction test 0.16. pLMWH does not seem to reduce the risk of OTI/death mild/moderate COVID-19 pneumonia, especially when respiratory function had already significantly deteriorated. Data from clinical trials comparing the effect of prophylactic vs. therapeutic dosage of LMWH at various stages of COVID-19 disease are needed.
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U2 - 10.1038/s41598-021-90713-6
DO - 10.1038/s41598-021-90713-6
M3 - Article
C2 - 34059708
AN - SCOPUS:85107404442
VL - 11
SP - 1
EP - 10
JO - Scientific Reports
JF - Scientific Reports
SN - 2045-2322
IS - 1
M1 - 11334
ER -