{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T12:46:19Z","timestamp":1747226779460,"version":"3.40.5"},"reference-count":29,"publisher":"King Faisal Specialist Hospital and Research Centre","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ann Saudi Med"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>Venous thromboembolism or extensive thrombosis is relatively common in patients with severe COVID-19 infection and has been associated with increased mortality. During the current COVID-19 pandemic, several prophylactic doses and types of low-molecular-weight heparin (LMWH) are being used worldwide; however, there are no high-quality studies or recommendations for an optimal prophylactic LMWH dose.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>OBJECTIVES:<\/jats:title>\n            <jats:p>Investigate the relationship between coagulation parameters and the LMWH dose, and mortality and ICU admission in hospitalized patients with severe COVID-19 pneumonia.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>DESIGN:<\/jats:title>\n            <jats:p>Retrospective.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>SETTING:<\/jats:title>\n            <jats:p>Tertiary care hospital.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>PATIENTS AND METHODS:<\/jats:title>\n            <jats:p>Data on clinical features, coagulation parameters and anticoagulant medications of inpatients with severe COVID-19 were collected for the period between 11 March 2020 and 31 April 2020.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>MAIN OUTCOME MEASURES:<\/jats:title>\n            <jats:p>Mortality and ICU admission for prophylactic dose LMWH (0.5 mg\/kg twice daily) and therapeutic dose LMWH (1 mg\/kg twice daily).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>SAMPLE SIZE:<\/jats:title>\n            <jats:p>154 cases.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>\n              Ninety-eight (63.6%) patients were treated with the LMWH prophylactic dose and 56 (36.4%) patients were treated with the therapeutic dose. Forty-four (44.9%) of 98 patients using the prophylactic dose LMWH died, while 10 (17.9%) of 56 patients using the therapeutic dose LMWH died (\n              <jats:italic>P<\/jats:italic>\n              =.001). Mortality was 6.4-fold higher in the prophylactic dose LMWH users than in the therapeutic dose LMWH users (OR=6.5, 95% CI: 2.4\u201317.6,\n              <jats:italic>P<\/jats:italic>\n              &lt;.001).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>Therapeutic dosing of LMWH may decrease mortality in patients with severe COVID-19 infected pneumonia. More aggressive thromboprophylaxis regimens using higher doses of heparin should be evaluated in prospective studies.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>LIMITATIONS:<\/jats:title>\n            <jats:p>Lack of information about bleeding complications. LMWH was not compared with other anticoagulant therapies. There was no comparison between our two groups on the APACHE score. Used different doses of LMWH in different clinics in our hospital. Single-center, retrospective study.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONFLICT OF INTEREST:<\/jats:title>\n            <jats:p>None.<\/jats:p>\n          <\/jats:sec>","DOI":"10.5144\/0256-4947.2020.462","type":"journal-article","created":{"date-parts":[[2020,12,13]],"date-time":"2020-12-13T13:56:57Z","timestamp":1607867817000},"page":"462-468","source":"Crossref","is-referenced-by-count":22,"title":["Therapeutic dosing of low-molecular-weight heparin may decrease mortality in patients with severe COVID-19 infection"],"prefix":"10.5144","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1579-3392","authenticated-orcid":true,"given":"Kadir","family":"Canoglu","sequence":"first","affiliation":[{"name":"From the Department of Pulmonology, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bengu","family":"Saylan","sequence":"additional","affiliation":[{"name":"From the Department of Pulmonology, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3134","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/j.ijsu.2020.02.034","article-title":"World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19).","volume":"76","author":"Sohrabi C","year":"2020","journal-title":"Int J Surg"},{"key":"e_1_3_1_3_2","unstructured":"World Health Organization. WHO Director-General's opening remarks at the media briefing on COVID-19 \u2013 11 March 2020. https:\/\/www.who.int\/dg\/speeches\/detail\/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19\u201311-march-2020 (Accessed on May 26 2020)"},{"key":"e_1_3_1_4_2","unstructured":"World Health Organization. WHO Coronavirus Disease (COVID-19) Dashboard. Updated on May 26 2020. https:\/\/covid19.who.int\/region\/euro\/country\/tr (Accessed on May 26 2020)"},{"issue":"10229","key":"e_1_3_1_5_2","doi-asserted-by":"crossref","first-page":"1054","DOI":"10.1016\/S0140-6736(20)30566-3","article-title":"Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study.","volume":"395","author":"Zhou F","year":"2020","journal-title":"Lancet"},{"issue":"1","key":"e_1_3_1_6_2","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1186\/s40249-020-00646-x","article-title":"Epidemiology, causes, clinical manifestation and diagnosis, prevention and control of coronavirus disease (COVID-19) during the early outbreak period: a scoping review.","volume":"9","author":"Adhikari SP","year":"2020","journal-title":"Infect Dis Poverty"},{"issue":"2","key":"e_1_3_1_7_2","doi-asserted-by":"crossref","first-page":"e16","DOI":"10.34172\/ipp.2020.16","article-title":"Acute respiratory distress syndrome in COVId-19 disease.","volume":"6","author":"Dadashzadeh N","year":"2020","journal-title":"Immunopathol Persa"},{"issue":"6","key":"e_1_3_1_8_2","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1016\/j.cmi.2020.03.026","article-title":"COVID-19, SARS and MERS: are they closely related?.","volume":"26","author":"Petrosillo N","year":"2020","journal-title":"Clin Microbiol Infect"},{"key":"e_1_3_1_9_2","doi-asserted-by":"crossref","first-page":"104362","DOI":"10.1016\/j.jcv.2020.104362","article-title":"Coagulation disorders in coronavirus infected patients: COVID-19, SARS-CoV-1, MERS-CoV and lessons from the past.","volume":"127","author":"Giannis D","year":"2020","journal-title":"J Clin Virol"},{"issue":"2","key":"e_1_3_1_10_2","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1056\/NEJMoa2015432","article-title":"Pulmonary Vascular Endothelialitis, Thrombosis, and Angiogenesis in Covid-19.","volume":"383","author":"Ackermann M","year":"2020","journal-title":"N Engl J Med"},{"issue":"4","key":"e_1_3_1_11_2","doi-asserted-by":"crossref","first-page":"844","DOI":"10.1111\/jth.14768","article-title":"Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia.","volume":"18","author":"Tang N","year":"2020","journal-title":"J Thromb Haemost"},{"issue":"5","key":"e_1_3_1_12_2","doi-asserted-by":"crossref","first-page":"1094","DOI":"10.1111\/jth.14817","article-title":"Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy.","volume":"18","author":"Tang N","year":"2020","journal-title":"J Thromb Haemost"},{"issue":"4","key":"e_1_3_1_13_2","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1093\/ehjcvp\/pvaa036","article-title":"Anticoagulation in COVID-19.","volume":"6","author":"Atallah B","year":"2020","journal-title":"Eur Heart J Cardiovasc Pharmacother"},{"key":"e_1_3_1_14_2","unstructured":"Kreuziger LB Lee A Garcia D Cuker A Cushman M DeSancho M et al. American Society of Hematology. COVID-19 and VTE\/Anticoagulation: Frequently Asked Questions. Updated on May 18 2020. https:\/\/www.hematology.org\/covid-19\/covid-19-and-vte-anticoagulation (Accessed on May 28 2020)."},{"issue":"5","key":"e_1_3_1_15_2","doi-asserted-by":"crossref","first-page":"1020","DOI":"10.1111\/jth.14821","article-title":"The versatile heparin in COVID-19.","volume":"18","author":"Thachil J","year":"2020","journal-title":"J Thromb Haemost"},{"issue":"12","key":"e_1_3_1_16_2","doi-asserted-by":"crossref","first-page":"2039","DOI":"10.3390\/jcm8122039","article-title":"Low Dose Low-Molecular-Weight Heparin for Thrombosis Prophylaxis: Systematic Review with Meta-Analysis and Trial Sequential Analysis.","volume":"8","author":"Eck RJ","year":"2019","journal-title":"J Clin Med"},{"key":"e_1_3_1_17_2","unstructured":"Republic of Turkey Ministry of Health. Guide of COVID-19 (SARS-Cov-2 infection). Updated on April 14 2020. https:\/\/covid19bilgi.saglik.gov.tr\/depo\/rehberler\/COVID-19_Rehberi.pdf?type=file (Accessed on May 26 2020)"},{"issue":"1","key":"e_1_3_1_18_2","first-page":"19","article-title":"Chinese expert consensus on diagnosis and treatment of coagulation dysfunction in COVID-19.","volume":"7","author":"Song JC","year":"2020","journal-title":"Mil Med Res"},{"key":"e_1_3_1_19_2","unstructured":"Khan IH Savarimuthu S Leung MST Harky A. The need to manage the risk of thromboembolism in COVID-19 patients [published online ahead of print 2020 May 14]. J Vasc Surg. 2020;S0741-5214(20)31157-5."},{"issue":"5","key":"e_1_3_1_20_2","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1111\/jth.14810","article-title":"ISTH interim guidance on recognition and management of coagulopathy in COVID-19.","volume":"18","author":"Thachil J","year":"2020","journal-title":"J Thromb Haemost"},{"key":"e_1_3_1_21_2","doi-asserted-by":"crossref","first-page":"e437","DOI":"10.1016\/S2665-9913(20)30121-1","article-title":"Immune mechanisms of pulmonary intravascular coagulopathy in COVID-19 pneumonia.","volume":"2","author":"McGonagle D","year":"2020","journal-title":"Lancet rheumatol"},{"key":"e_1_3_1_22_2","unstructured":"World Health Organization. Clinical management of COVID-19 interim guidance. Updated on May 27 2020. https:\/\/www.who.int\/publications-detail\/clinical-management-of-covid-19 (Accessed on May 30 2020)"},{"issue":"6","key":"e_1_3_1_23_2","doi-asserted-by":"crossref","first-page":"e438","DOI":"10.1016\/S2352-3026(20)30145-9","article-title":"Coagulation abnormalities and thrombosis in patients with COVID-19.","volume":"7","author":"Levi M","year":"2020","journal-title":"Lancet Haematol"},{"issue":"1","key":"e_1_3_1_24_2","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1186\/s13063-020-04475-z","article-title":"Randomised controlled trial comparing efficacy and safety of high versus low Low-Molecular Weight Heparin dosages in hospitalized patients with severe COVID-19 pneumonia and coagulopathy not requiring invasive mechanical ventilation (COVID-19 HD): a structured summary of a study protocol.","volume":"21","author":"Marietta M","year":"2020","journal-title":"Trials"},{"key":"e_1_3_1_25_2","unstructured":"West Suffolk NHS Foundation Trust. Clinical Guideline CG10393-2. Thromboprophylaxis and Anticoagulation in COVID-19 infection. Updated on May 01 2020. https:\/\/www.wsh.nhs.uk\/covid-staff-zone\/Guidelines-SOPs-clinical-info\/Docs\/Clinical-guideline\/CG10393-COVIDThromboprophylaxis-and-Anticoagulation-in-COVID-19-infections.pdf (Accessed on May 30 2020)."},{"issue":"1","key":"e_1_3_1_26_2","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1007\/s11239-020-02146-z","article-title":"Systematic assessment of venous thromboembolism in COVID-19 patients receiving thromboprophylaxis: incidence and role of D-dimer as predictive factors.","volume":"50","author":"Artifoni M","year":"2020","journal-title":"J Thromb Thrombolysis"},{"issue":"5","key":"e_1_3_1_27_2","doi-asserted-by":"crossref","first-page":"876","DOI":"10.1055\/s-0040-1709650","article-title":"D-dimer is Associated with Severity of Coronavirus Disease 2019: A Pooled Analysis.","volume":"120","author":"Lippi G","year":"2020","journal-title":"Thromb Haemost"},{"issue":"23","key":"e_1_3_1_28_2","doi-asserted-by":"crossref","first-page":"2950","DOI":"10.1016\/j.jacc.2020.04.031","article-title":"COVID-19 and Thrombotic or Thromboembolic Disease: Implications for Prevention, Antithrombotic Therapy, and Follow-up: JACC State-of-the-Art Review.","volume":"75","author":"Bikdeli B","year":"2020","journal-title":"J Am Coll Cardiol"},{"key":"e_1_3_1_29_2","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.cca.2020.03.022","article-title":"Thrombocytopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: A meta-analysis.","volume":"506","author":"Lippi G","year":"2020","journal-title":"Clin Chim Acta"},{"key":"e_1_3_1_30_2","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/j.ejim.2020.05.002","article-title":"Bleeding in COVID-19 severe pneumonia: The other side of abnormal coagulation pattern?","volume":"77","author":"Conti CB","year":"2020","journal-title":"Eur J Intern Med"}],"container-title":["Annals of Saudi Medicine"],"original-title":[],"language":"en","deposited":{"date-parts":[[2020,12,13]],"date-time":"2020-12-13T13:57:21Z","timestamp":1607867841000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.annsaudimed.net\/doi\/10.5144\/0256-4947.2020.462"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11]]},"references-count":29,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2020,11]]}},"alternative-id":["10.5144\/0256-4947.2020.462"],"URL":"https:\/\/doi.org\/10.5144\/0256-4947.2020.462","relation":{},"ISSN":["0256-4947","0975-4466"],"issn-type":[{"type":"print","value":"0256-4947"},{"type":"electronic","value":"0975-4466"}],"subject":[],"published":{"date-parts":[[2020,11]]}}}