Adult patients hospitalized with COVID-19 and treated with either unfractionated heparin (UFH) or low molecular weight heparin (LMWH) for hypercoagulation complications show significant decrease in D-dimer level, suggesting a similar effectiveness for both drugs, according to study findings published in the Annals of Medicine and Surgery.

Researchers sought to compare the effectiveness of UFH and LMWH in patients hospitalized with COVID-19 with hypercoagulation complications. They initiated a retrospective analytical observational cohort study using medical records of inpatients with COVID-19 at the Islamic Hospital Jakarta Sukapura in Jakarta, Indonesia, between August 2020 and August 2021. They found 98 patients aged 21 years or older (30.6% aged >60 years; 52% women), of whom 63 patients were treated with LMWH and 35 patients were treated with UFH.

The researchers noted that the greatest decrease in D-dimer level (0.01±0.5 g fibrinogen equivalent units/mL) occurred in 34.3% of patients in the UFH group and in 23.8% of patients in the LMWH group. Overall, 77.1% of patients on UFH saw a decrease in D-dimer level and 22.9% experienced an increase in D-dimer level. Similarly, about 74.6% of patients on LMWH saw a decrease in D-dimer level and 25.4% experienced an increase in D-dimer level. Most patients with confirmed COVID-19 were women aged 50 to 59 years.


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Study limitations include its retrospective design and the incomplete secondary data in medical records. The study was also powered due to the sample size.

“…patients in both treatment groups (UFH and LMWH [fondaparinux]) showed a significant decrease in D-dimer values, suggesting that both drugs have a similar effectiveness in the treatment of coagulopathy,” the researchers wrote.

Reference

Fachri M, Hatta M, Tarigan SNNA, et al. Heparin for patients with coronavirus disease 2019 and hypercoagulation complications: a cohort study. Ann Med Surg (Lond). Published online June 28, 2022. doi:10.1016/j.amsu.2022.104042