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. 2021 Feb 11:12:69-75.
doi: 10.2147/JBM.S285214. eCollection 2021.

Antithrombotic and Anti-Inflammatory Effects of Fondaparinux and Enoxaparin in Hospitalized COVID-19 Patients: The FONDENOXAVID Study

Giuseppe Cardillo  1 , Giuseppe Vito Viggiano  2 , Vincenzo Russo  3 , Sara Mangiacapra  4 , Antonella Cavalli  5 , Giampiero Castaldo  2 , Federica Agrusta  2 , Annamaria Bellizzi  5 , Maria Amitrano  4 , Mariateresa Iannuzzo  6 , Clara Sacco  7 , Corrado Lodigiani  7 , Andrea Fontanella  6 , Pierpaolo Di Micco  6 ; FondenoxavidStudy Group
Affiliations

Antithrombotic and Anti-Inflammatory Effects of Fondaparinux and Enoxaparin in Hospitalized COVID-19 Patients: The FONDENOXAVID Study

Giuseppe Cardillo et al. J Blood Med. .

Abstract

Background: Since the outbreak of novel coronavirus SARS-CoV2 around the world, great attention has been paid to the effects of such antithrombotic drugs as heparinoids, because they have antiviral action in vitro and antithrombotic actions in vivo. We conducted a retrospective analysis in inpatients with confirmed COVID-19 on the anti-inflammatory and antithrombotic effects of enoxaparin and fondaparinux at prophylactic doses.

Methods: This retrospective cohort study used patients with confirmed COVID-19 during the first months of the Italian outbreak from February 18 to April 30, 2020. Our aim was to compare clinical characteristics, prophylactic treatment, markers of inflammation, and thrombotic outcomes in inpatients positive for SARS-CoV2 during hospitalization associated with thromboprophylaxis with enoxaparin (40 mg or 60 mg once daily) or fondaparinux (2.5 mg once daily). Statistical analysis was conducted with using MatLab R2016B and ad hoc functions.

Results: There were no significatant differences in clinical characteristics between patients that used enoxaparin or fondaparinux as thromboprophylaxis for SARS-CoV2. No differences were found in D-dimer and fibrinogen levels either, which were used as markers of inflammation during the infection at testing on admission and after 3 weeks.Significant differences in CRP, IL6, and LDH were found in patients after 21 days' treatment.

Discussion: Increased levels of fibrinogen and D-dimer in patients with confirmed COVID-19 have been reported in several studies. Our results showed that anti-inflammatory effects of fondaparinux and enoxaparin after 3 weeks of prophylactic treatment were similar when levels of fibrinogen and D-dimer were considered. Furthermore, levels of CRP showed a decrease in patients treated with enoxaparin and fondaparinux, although the decrease in the fondaparinux group seems to be more relevant.

Keywords: COVID-19; D-dimer; SARS-CoV2; enoxaparin; fibrinogen; fondaparinux; venous thromboembolism.

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Conflict of interest statement

The authors certify that they have no conflicts of interest to declare for this report.

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