Effect of enoxaparin on d-dimer level and survival in hospitalized COVID-19 patients
An observational study
Keywords:
COVID-19, enoxaparin, D-dimerAbstract
Coronavirus disease 2019 (COVID-19), is caused by Severe Acute Respiratory Syndrome Coronavirus 2(SARS-CoV-2) infection. It is associated with a severe coagulopathy i.e. Venous Thrombo-embolism (VTE), for which optimum strategies ought to be developed for early treatment. D-dimer, a fibrin degradation product is raised in critical COVID-19 pneumonia and increases mortality. Enoxaparin, a low molecular weight heparin, has shown beneficial results in prevention and treatment of VTE. During management of COVID 19 patient with subcutaneous enoxaparin a decrease in D-dimer level is expected primarily because of decreased coagulation leading to decreased fibrin production. It was an observational study with data collected from 86 patients admitted to dedicated COVID hospital, VIMSAR, Burla, Odisha, from April 2022 to August 2022. Medical records of all hospitalized COVID-19 patients with D-dimer and prescribed enoxaparin (40mg s.c.) were analyzed with due permission from authorities. D-dimer level was evaluated before and after treatment with enoxaparin (on day of admission and day 5). Total 86 case records were analyzed and there was significant reduction in D-dimer level in covid patients after subcutaneous enoxaparin. (z value= -5.265,p value ooo1). Data analysis was done in SPSS software version 21 using a Nonparametric Test i.e.
Downloads
References
Connors JM, Levy JH. COVID-19 and its implications for thrombosis and anticoagulation.Blood 2020;135:2033–40.
Demelo-Rodríguez P, Cervilla-Muñoz E, Ordieres-Ortega L, et al. Incidence of asymptomatic deep vein thrombosis in patients with COVID-19 pneumonia and elevated D-dimer levels. Thromb Res. 2020;192:23–26. doi:10.1016/j.thromres.2020.05.018
Garcia DA, Baglin TP, Weitz JI, Samama MM. Parenteral anticoagulants:antithrombotic therapy and prevention of thrombosis, 9th ed: AmericanCollege of Chest Physicians evidence-based clinical practice guidelines.Chest. 2012;141(Suppl 2):e24S–E43s
Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, Liu L, Shan H, Lei CL, Hui DSC, Du B, Li LJ, Zeng G, Yuen KY, Chen RC, Tang CL, Wang T, Chen PY, Xiang J, Li SY, Wang JL, Liang ZJ, Peng YX, Wei L, Liu Y, Hu YH, Peng P, Wang JM, Liu JY, Chen Z, Li G, Zheng ZJ, Qiu SQ, Luo J, Ye CJ, Zhu SY, Zhong NS; China Medical Treatment Expert Group for Covid-19. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020 Apr 30;382(18):1708-1720. doi: 10.1056/NEJMoa2002032. Epub 2020 Feb 28. PMID: 32109013; PMCID: PMC7092819.
Iba T, Nisio MD, Levy JH, Kitamura N, Thachil J. New criteria forsepsis-induced coagulopathy (SIC) following the revised sepsis definition:a retrospective analysis of a nationwide survey. BMJ Open.2017;7(9):e017046
Miesbach W, Makris M. COVID-19: coagulopathy, risk of thrombosis, and the rationale for anticoagulation. ClinApplThrombHemost 2020;26:107602962093814.50.
Porfidia A, Pola R. Venous thromboembolism in COVID-19 patients. J ThrombHaemost. 2020;18(6):1516–1517. doi:10.1111/jth.14842
Published
How to Cite
Issue
Section
Copyright (c) 2022 International journal of health sciences
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Articles published in the International Journal of Health Sciences (IJHS) are available under Creative Commons Attribution Non-Commercial No Derivatives Licence (CC BY-NC-ND 4.0). Authors retain copyright in their work and grant IJHS right of first publication under CC BY-NC-ND 4.0. Users have the right to read, download, copy, distribute, print, search, or link to the full texts of articles in this journal, and to use them for any other lawful purpose.
Articles published in IJHS can be copied, communicated and shared in their published form for non-commercial purposes provided full attribution is given to the author and the journal. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
This copyright notice applies to articles published in IJHS volumes 4 onwards. Please read about the copyright notices for previous volumes under Journal History.