{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T21:49:17Z","timestamp":1790372957397,"version":"4.1.0"},"reference-count":31,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,1,19]],"date-time":"2022-01-19T00:00:00Z","timestamp":1642550400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brit J Clinical Pharma"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>To determine the safety and efficacy\u2010potential of inhaled nebulised unfractionated heparin (UFH) in the treatment of hospitalised patients with COVID\u201019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective, uncontrolled multicentre single\u2010arm case series of hospitalised patients with laboratory\u2010confirmed COVID\u201019, treated with inhaled nebulised UFH (5000\u2009IU q8h, 10\u2009000\u2009IU q4h, or 25\u2009000\u2009IU q6h) for 6\u2009\u00b1\u20093 (mean\u2009\u00b1\u2009standard deviation) days. Outcomes were activated partial thromboplastin time (APTT) before treatment (baseline) and highest\u2010level during treatment (peak), and adverse events including bleeding. Exploratory efficacy outcomes were oxygenation, assessed by ratio of oxygen saturation to fraction of inspired oxygen (FiO<jats:sub>2<\/jats:sub>) and FiO<jats:sub>2<\/jats:sub>, and the World Health Organisation modified ordinal clinical scale.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 98 patients included. In patients on stable prophylactic or therapeutic systemic anticoagulant therapy but not receiving therapeutic UFH infusion, APTT levels increased from baseline of 34\u2009\u00b1\u200910\u00a0seconds to a peak of 38\u2009\u00b1\u200911\u2009seconds (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.0001). In 3 patients on therapeutic UFH infusion, APTT levels did not significantly increase from baseline of 72\u2009\u00b1\u200920 to a peak of 84\u2009\u00b1\u200928\u2009seconds (<jats:italic>P<\/jats:italic>\u2009=\u2009.17). Two patients had serious adverse events: bleeding gastric ulcer requiring transfusion and thigh haematoma; both were on therapeutic anticoagulation. Minor bleeding occurred in 16 patients, 13 of whom were on therapeutic anticoagulation. The oxygen saturation\/FiO<jats:sub>2<\/jats:sub> ratio and the FiO<jats:sub>2<\/jats:sub> worsened before and improved after commencement of inhaled UFH (change in slope, <jats:italic>P<\/jats:italic>\u00a0&lt;\u2009.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Inhaled nebulised UFH in hospitalised patients with COVID\u201019 was safe. Although statistically significant, inhaled nebulised UFH did not produce a clinically relevant increase in APTT (peak values in the normal range). Urgent randomised evaluation of nebulised UFH in patients with COVID\u201019 is warranted and several studies are currently underway.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bcp.15212","type":"journal-article","created":{"date-parts":[[2022,1,5]],"date-time":"2022-01-05T01:53:33Z","timestamp":1641347613000},"page":"2802-2813","source":"Crossref","is-referenced-by-count":31,"title":["Inhaled nebulised unfractionated heparin for the treatment of hospitalised patients with COVID\u201019: A multicentre case series of 98 patients"],"prefix":"10.1111","volume":"88","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8037-4229","authenticated-orcid":false,"given":"Frank M. 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