Abstract | PURPOSE: METHODS: We conducted a retrospective study of patients consecutively enrolled from two major academic hospitals exclusively for COVID-19 in Wuhan, China, from January 26, 2020, to March 26, 2020. The primary outcome was adjusted in-hospital mortality in the LMWH group compared with the non- LMWH group using the propensity score. RESULTS: Overall, 525 patients with COVID-19 enrolled with a median age of 64 years (IQR 19), and 49.33% men. Among these, 120 (22.86%) were treated with LMWH. Compared with the non- LMWH group, the LMWH group was more likely to be older and male; had a history of hypertension, diabetes, coronary heart disease (CHD), or stroke; and had more severe COVID-19 parameters such as higher inflammatory cytokines or D-dimer. Compared with non- LMWH group, LMWH group had a higher unadjusted in-hospital mortality rate (21.70% vs. 11.10%; p = 0.004), but a lower adjusted mortality risk (adjusted odds ratio [OR], 0.20; 95% CI, 0.09-0.46). A propensity score-weighting analysis demonstrated similar findings (adjusted OR, 0.18; 95% CI, 0.10-0.30). Subgroup analysis showed a significant survival benefit among those who were severely (adjusted OR, 0.07; 95% CI, 0.02-0.23) and critically ill (adjusted OR, 0.32; 95% CI, 0.15-0.65), as well as among the elderly patients' age > 65, IL-6 > 10 times upper limit level, and D-dimer > 5 times upper limit level. CONCLUSIONS: Among hospitalized COVID-19 patients, LMWH use was associated with lower all-cause in-hospital mortality than non- LMWH users. The survival benefit was particularly significant among more severely ill patients.
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Authors | Lan Shen, Lin Qiu, Dong Liu, Li Wang, Hengye Huang, Heng Ge, Ying Xiao, Yi Liu, Jingjin Jin, Xiulan Liu, Dao Wen Wang, Eric D Peterson, Ben He, Ning Zhou |
Journal | Cardiovascular drugs and therapy
(Cardiovasc Drugs Ther)
Vol. 36
Issue 1
Pg. 113-120
(02 2022)
ISSN: 1573-7241 [Electronic] United States |
PMID | 33394360
(Publication Type: Journal Article, Multicenter Study, Observational Study)
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Copyright | © 2021. Springer Science+Business Media, LLC, part of Springer Nature. |
Chemical References |
- Anticoagulants
- Heparin, Low-Molecular-Weight
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Topics |
- Aged
- Aged, 80 and over
- Anticoagulants
(adverse effects, therapeutic use)
- Blood Coagulation
(drug effects)
- COVID-19
(diagnosis, mortality)
- China
(epidemiology)
- Comorbidity
- Female
- Hemorrhage
(chemically induced)
- Heparin, Low-Molecular-Weight
(adverse effects, therapeutic use)
- Hospital Mortality
- Hospitalization
- Humans
- Male
- Middle Aged
- Retrospective Studies
- Risk Assessment
- Risk Factors
- Severity of Illness Index
- Time Factors
- Treatment Outcome
- COVID-19 Drug Treatment
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