Session Type: 1-hour Oral Session
Session Title: 1-hour Oral Session
Authors(s): A. De Vito (1), L. Saderi (2), V. Fiore (1), N. Geremia (1), E. Princic (1), A.A. Muredda (1), C. Fanelli (1), I. Maida (1), C.M. Panu Napodano (1), E. Bogliolo (1), G. Moi (1), A.G. Fois (3), G. Sotgiu (2), G. Madeddu (1), S. Babudieri (1)
Authors Affiliations(s): (1) Unit Of Infectious Diseases, Department Of Medical, Surgical And Experimental Sciences, University of Sassari, Italy, (2) Clinical Epidemiology and Medical Statistics Unit Department of Medical, Surgical and Experimental Sciences, University of Sassari, Italy, (3) Clinical and Interventional Pulmonology, Department Of Medical, Surgical And Experimental Sciences, University of Sassari, Italy
Background:
Since the beginning of the SARS-CoV-2 pandemic, millions of people have been infected, and thousands have died. Different therapeutic approaches have been recommended, but only a few have shown clinical advantages. Low-molecular-weight heparin (LMWH) has been recommended to prevent COVID-19-related thrombo-embolic events.
Methods:An observational retrospective study was performed in an Italian university hospital to evaluate the preventive role of LMWH on the mortality rate of COVID-19 patients. SARS-CoV-2 infected patients were recruited from the beginning of the Italian epidemic to December 31st, 2020. We excluded patients with missing data and those chronically exposed to heparin. Enoxaparin 4,000 IU or 2,000 IU in cases of eGFR <30ml/min was daily prescribed. Qualitative and quantitative variables were summarized with frequencies and medians (interquartile ranges, IQR). Logistic regression analysis was performed to assess the relationship between clinical and epidemiological variables and mortality.
Results:A total of 622 SARS-CoV-2 infected patients were recruited, with 277 (44.5%) males and a median (IQR) age of 78.7 (64.4-86) years. The most prevalent comorbidity was hypertension (58.2%), followed by cardiovascular disease, neurological, and psychiatric disorders (197, 194, and 189 cases, respectively). 73.5% developed SARS-CoV-2-related symptoms and 55.6% were admitted to the hospital, and 18.7% died.
Four hundred-two (64.6%) started LMWH. In particular, 246 (39.6%) and 189 (30.4%) were treated within 5 and 3days since symptoms onset, respectively. Early treatment (within 3 or 5 days since symptoms onset) was associated with a decreased mortality.
Age, diabetes, and neurological disorders were associated with an increased risk of death. Patients exposed to LMWH within 5 days since symptoms onset had a lower risk of death (Table 1).
Conclusions:An early preventive therapy with LMWH was associated with a lower mortality rate. Following a risk-benefit assessment, the earliest LMWH administration after symptoms’ onset should be recommended for infected patients with comorbidities or with older age. Future studies should be performed to evaluate treatment duration.
Keyword(s): COVID-19 treatment, Low-molecular-weight heparin, SARS-CoV-2COI Other: The authors declare not having conflicts of interest.
Session Type: 1-hour Oral Session
Session Title: 1-hour Oral Session
Authors(s): A. De Vito (1), L. Saderi (2), V. Fiore (1), N. Geremia (1), E. Princic (1), A.A. Muredda (1), C. Fanelli (1), I. Maida (1), C.M. Panu Napodano (1), E. Bogliolo (1), G. Moi (1), A.G. Fois (3), G. Sotgiu (2), G. Madeddu (1), S. Babudieri (1)
Authors Affiliations(s): (1) Unit Of Infectious Diseases, Department Of Medical, Surgical And Experimental Sciences, University of Sassari, Italy, (2) Clinical Epidemiology and Medical Statistics Unit Department of Medical, Surgical and Experimental Sciences, University of Sassari, Italy, (3) Clinical and Interventional Pulmonology, Department Of Medical, Surgical And Experimental Sciences, University of Sassari, Italy
Background:
Since the beginning of the SARS-CoV-2 pandemic, millions of people have been infected, and thousands have died. Different therapeutic approaches have been recommended, but only a few have shown clinical advantages. Low-molecular-weight heparin (LMWH) has been recommended to prevent COVID-19-related thrombo-embolic events.
Methods:An observational retrospective study was performed in an Italian university hospital to evaluate the preventive role of LMWH on the mortality rate of COVID-19 patients. SARS-CoV-2 infected patients were recruited from the beginning of the Italian epidemic to December 31st, 2020. We excluded patients with missing data and those chronically exposed to heparin. Enoxaparin 4,000 IU or 2,000 IU in cases of eGFR <30ml/min was daily prescribed. Qualitative and quantitative variables were summarized with frequencies and medians (interquartile ranges, IQR). Logistic regression analysis was performed to assess the relationship between clinical and epidemiological variables and mortality.
Results:A total of 622 SARS-CoV-2 infected patients were recruited, with 277 (44.5%) males and a median (IQR) age of 78.7 (64.4-86) years. The most prevalent comorbidity was hypertension (58.2%), followed by cardiovascular disease, neurological, and psychiatric disorders (197, 194, and 189 cases, respectively). 73.5% developed SARS-CoV-2-related symptoms and 55.6% were admitted to the hospital, and 18.7% died.
Four hundred-two (64.6%) started LMWH. In particular, 246 (39.6%) and 189 (30.4%) were treated within 5 and 3days since symptoms onset, respectively. Early treatment (within 3 or 5 days since symptoms onset) was associated with a decreased mortality.
Age, diabetes, and neurological disorders were associated with an increased risk of death. Patients exposed to LMWH within 5 days since symptoms onset had a lower risk of death (Table 1).
Conclusions:An early preventive therapy with LMWH was associated with a lower mortality rate. Following a risk-benefit assessment, the earliest LMWH administration after symptoms’ onset should be recommended for infected patients with comorbidities or with older age. Future studies should be performed to evaluate treatment duration.
Keyword(s): COVID-19 treatment, Low-molecular-weight heparin, SARS-CoV-2COI Other: The authors declare not having conflicts of interest.