{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,8]],"date-time":"2026-02-08T01:25:08Z","timestamp":1770513908417,"version":"3.49.0"},"reference-count":65,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2021,12,11]],"date-time":"2021-12-11T00:00:00Z","timestamp":1639180800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Low molecular weight heparin, enoxaparin, has been one of most used drugs to fight the SARS-CoV-2 pandemic. Pharmacological properties of heparin recognize its specific ability, as with other oligosaccharides and glycosaminoglycan, to bind several types of viruses during their pass through the extracellular matrix of the respiratory tract, as well as its anticoagulant activity to prevent venous thromboembolism. Antithrombotic actions of enoxaparin have been testified both for inpatients with COVID-19 in regular ward and for inpatients in Intensive Care Units (ICUs). Prophylactic doses seem to be able to prevent venous thromboembolism (VTE) in inpatients in the regular ward, while intermediate or therapeutic doses have been frequently adopted for inpatients with COVID-19 in ICU. On the other hand, although we reported several useful actions of heparin for inpatients with COVID-19, an increased rate of bleeding has been recorded, and it may be related to several conditions such as underlying diseases with increased risks of bleeding, increased doses or prolonged administration of heparin, personal trend to bleed, and so on.<\/jats:p>","DOI":"10.3390\/v13122486","type":"journal-article","created":{"date-parts":[[2021,12,13]],"date-time":"2021-12-13T03:14:29Z","timestamp":1639365269000},"page":"2486","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Heparin and SARS-CoV-2: Multiple Pathophysiological Links"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8484-4598","authenticated-orcid":false,"given":"Pierpaolo","family":"Di Micco","sequence":"first","affiliation":[{"name":"Department of Medicine, Buon Consiglio Fatebenefratelli Hospital of Naples, 80122 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2656-5467","authenticated-orcid":false,"given":"Egidio","family":"Imbalzano","sequence":"additional","affiliation":[{"name":"Dipartimento Di ClinicaMedica E Farmacologia, University of Messina, 98100 Messina, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9227-0360","authenticated-orcid":false,"given":"Vincenzo","family":"Russo","sequence":"additional","affiliation":[{"name":"Department of Translational Medical Sciences, University of Campania \u201cLuigi Vanvitelli\u201d\u2014Monaldi Hospital, Piazzale Ettore Ruggeri, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emilio","family":"Attena","sequence":"additional","affiliation":[{"name":"Division of Cardiology, San Giuliano Hospital, 80014 Giugliano in Campania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincenzo","family":"Mandaliti","sequence":"additional","affiliation":[{"name":"Comegen Oupatients Clinic, 80124 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luana","family":"Orlando","sequence":"additional","affiliation":[{"name":"Dipartimento Di ClinicaMedica E Farmacologia, University of Messina, 98100 Messina, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maurizio","family":"Lombardi","sequence":"additional","affiliation":[{"name":"Cardiocenter Outpatients Clinic, 80121 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianluca","family":"Di Micco","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Ospedale Buon Consiglio, Fatebenefratelli, 80122 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0881-5429","authenticated-orcid":false,"given":"Giuseppe","family":"Camporese","sequence":"additional","affiliation":[{"name":"Unit of Angiology, Department of Cardiac, Thoracic and Vascular Sciences, Padua University, 35100 Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saverio","family":"Annunziata","sequence":"additional","affiliation":[{"name":"Comegen Oupatients Clinic, 80124 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gaetano","family":"Piccinocchi","sequence":"additional","affiliation":[{"name":"Comegen Oupatients Clinic, 80124 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Walter","family":"Pacelli","sequence":"additional","affiliation":[{"name":"Cardiocenter Outpatients Clinic, 80121 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele","family":"Del Guercio","sequence":"additional","affiliation":[{"name":"Angiology Outpatients Clinic, 80122 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,12,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1007\/978-3-642-23056-1_8","article-title":"Heparin and heparansulfate: Analyzing structure and microheteroge-neity","volume":"207","author":"Shriver","year":"2012","journal-title":"Heparin-A Century Prog."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1016\/bs.ircmb.2016.02.009","article-title":"HeparanSulfate: Biosynthesis, Structure, and Function","volume":"325","author":"Li","year":"2016","journal-title":"Int. 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