Anticoagulation in patients with severe SARS-CoV-2 pneumonia in ICU
DOI:
https://doi.org/10.35381/s.v.v9i1.4709Keywords:
Anticoagulation, SARS-CoV-2, intensive care units; thromboembolism, (Source: DeCS).Abstract
Objective: To determine anticoagulation in patients with severe SARS-CoV-2 pneumonia admitted to intensive care unit. Method: Literature review of evidence on anticoagulants in COVID-19 patients in ICU. Database search in PubMed, Cochrane, Scielo, Science Direct and Scopus under MeSH terms. Analytical studies, clinical trials and systematic reviews from 2022 were included. Results: From 157 initial studies, after applying inclusion and exclusion criteria, 13 investigations were analyzed. Critical COVID-19 patients present cumulative incidence of thrombotic complications of 25% at 7 days and 48% at 14 days. Low molecular weight heparin at therapeutic doses reduces mortality especially in patients with elevated D-dimer. Conclusions: Both prophylactic and therapeutic anticoagulation reduces thrombotic complications, but high hemorrhagic risk exists requiring individualized treatment.
Downloads
References
Quezada JT, Benítez Guerrero M. Tromboprofilaxis y anticoagulación en pacientes con COVID-19. 2020.
Benalcázar Freire JF, Tipantaxi Flores SS, Benítez Guerrero MA. SARS-CoV-2 and venous thromboembolic disease. Angiología. 2020.
Klok FA, Kruip MJHA, van der Meer NJM, Arbous MS, Gommers DAMPJ, Kant KM, et al. Incidence of thrombotic complications in critically ill ICU patients with COVID-19. Thromb Res. 2020;191:145-7.
Middeldorp S, Coppens M, Haaps TF, Foppen M, Vlaar AP, Müller MCA, et al. Incidence of venous thromboembolism in hospitalized patients with COVID‐19. J Thromb Haemost. 2020;18(8):1995-2002.
Ranucci M, Ballotta A. The procoagulant pattern of patients with COVID-19 acute respiratory distress syndrome. J Thromb Haemost. 2020;18(7):1747-51.
Cui S, Chen S, Li X, Liu S, Wang F. Prevalence of venous thromboembolism in patients with severe novel coronavirus pneumonia. J Thromb Haemost. 2020;18(6):1421-4.
Guan W, Ni Z, Hu Y, Liang W, Ou C, He J, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708-20.
Tang N, Bai H, Chen X, Gong J, Li D, Sun Z. Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy. J Thromb Haemost. 2020;18(5):1094-9.
Canoglu K, Saylan B. Therapeutic dosing of low-molecular-weight heparin may decrease mortality in patients with severe COVID-19 infection. Ann Saudi Med. 2020;40(6):462-8.
Falcone M, Tiseo G, Barbieri G, Galfo V, Russo A, Virdis A, et al. Role of low-molecular-weight heparin in hospitalized patients with severe acute respiratory syndrome coronavirus 2 pneumonia. J Cardiovasc Med. 2020;21(12):926-9.
Apostolos K, Konstantinos L, Georgios T, Ioannis S, Cheva A, Gkioti A, et al. D-dimer-driven anticoagulation reduces mortality in intubated COVID-19 patients. Respir Med. 2021;181:106377.
AlSamkari H, Karp Leaf RS, Dzik WH, Carlson JCT, Fogerty AE, Waheed A, et al. COVID-19 and coagulation. Blood. 2020;136(4):489-98.
REMAP-CAP Investigators. Therapeutic anticoagulation with heparin in critically ill patients with Covid-19. N Engl J Med. 2021;385(9):777-89.
Lemos ACB, do Espírito Santo DA, Salvetti MC, Gilio RN, Agra LB, et al. Therapeutic versus prophylactic anticoagulation for severe COVID-19. Thromb Haemost. 2020;120(12):1691-700.
Morici N, Podda GM, Birocchi S, De Marco F, Merli M, Cantoni S, et al. Enoxaparin for thromboprophylaxis in hospitalized COVID-19 patients. Eur J Clin Invest. 2022;52(1):e13698.
Paranjpe I, Fuster V, Lala A, Russak AJ, Glicksberg BS, et al. Association of treatment dose anticoagulation with in-hospital survival among hospitalized patients with COVID-19. J Am Coll Cardiol. 2020;76(1):122-4.
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Ángel Mauricio Morocho-Saquinaula, Elsa Josefina Albornoz-Zamora, Riber Fabián Donoso-Noroña
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
CC BY-NC-SA : Esta licencia permite a los reutilizadores distribuir, remezclar, adaptar y construir sobre el material en cualquier medio o formato solo con fines no comerciales, y solo siempre y cuando se dé la atribución al creador. Si remezcla, adapta o construye sobre el material, debe licenciar el material modificado bajo términos idénticos.
OAI-PMH: https://fundacionkoinonia.com.ve/ojs/index.php/saludyvida/oai.
