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. 2022 Dec;18(12):4048-4055.
doi: 10.1016/j.sapharm.2022.07.004. Epub 2022 Jul 16.

Thromboprophylaxis and clinical outcomes in moderate COVID-19 patients: A comparative study

Asmaa S Mohamed  1 , Hosam M Ahmad  2 , Alyaa S A Abdul-Raheem  3 , Fatma M M Kamel  4 , Ali Khames  5 , Ahmed F Mady  6
Affiliations

Thromboprophylaxis and clinical outcomes in moderate COVID-19 patients: A comparative study

Asmaa S Mohamed et al. Res Social Adm Pharm. 2022 Dec.

Abstract

Background: Many thrombotic complications are linked to coronavirus disease 2019 (COVID-19). Antithrombotic treatments are important for prophylaxis against these thrombotic events.

Objectives: This study was designed to compare enoxaparin and rivaroxaban as prophylactic anticoagulants in moderate cases of COVID-19 in terms of efficacy, safety, and clinical outcomes.

Methods: The study involved 124 patients with moderate COVID-19 (pneumonia without hypoxia) divided into two groups. The first group (G1) comprised 66 patients who received enoxaparin subcutaneously at a dose of 0.5 mg/kg every 12 h until discharge from the hospital. The second group (G2) comprised 58 patients who received oral rivaroxaban at a dose of 10 mg once daily until discharge from the hospital. The outcomes evaluated in this study were as follows: intermediate care unit (IMCU) duration, the number of patients transferred from the IMCU to the intensive care unit (ICU), ICU duration, the total length of hospital stay, in-hospital mortality, and thrombotic and bleeding complications.

Results: No significant differences in IMCU duration (p = 0.39), ICU duration (p = 0.96), and total length of hospital stay (p = 0.73) were observed between the two groups. The percentage of patients requiring ICU admission after hospitalization was 21.2% in G1 and 22.4% in G2 (p = 0.87). The mortality rate was 12.1% in G1 and 10.3% in G2 (p = 0.76). The proportion of patients who had thrombotic complications was 9.1% in G1 and 12.1% in G2 (p = 0.59). The incidence of mild bleeding was 3% in G1 and 1.7% in G2 (p = 0.64).

Conclusion: Either enoxaparin or rivaroxaban may be used as thromboprophylaxis agents in managing patients with moderate COVID-19. Either medication has no clear advantage over the other.

Keywords: Anticoagulants; COVID-19; Enoxaparin; Rivaroxaban; Thromboprophylaxis.

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Conflict of interest statement

Declaration of competing interest All authors have no conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1
Inclusion and exclusion criteria.
Fig. 2
Fig. 2
Flow Diagram of the studied sample.
Fig. 3
Fig. 3
Comparison of the outcomes between the two groups. (Intermediate care unit duration, intensive care unit duration, and length of hospital stay).
Fig. 4
Fig. 4
Comparison of the outcomes and adverse events between the two groups.
Fig. 5
Fig. 5
Correlation between total length of hospital stay and some laboratory data.
See this image and copyright information in PMC

References

    1. Chandra A., Chakraborty U., Ghosh S., Dasgupta S. Anticoagulation in COVID-19: current concepts and controversies. Postgrad Med. 2021 - PubMed
    1. Miesbach W., Makris M. COVID-19: coagulopathy, risk of thrombosis, and the rationale for anticoagulation. Clin Appl Thromb Hemost. 2020;26 - PMC - PubMed
    1. Ahmed S., Zimba O., Gasparyan A.Y. Clinical rheumatology; 2020. Thrombosis in Coronavirus Disease 2019 (COVID-19) through the Prism of Virchow's Triad; pp. 1–15. - PMC - PubMed
    1. Bourgonje A.R., Abdulle A.E., Timens W., et al. Angiotensin‐converting enzyme 2 (ACE2), SARS‐CoV‐2 and the pathophysiology of coronavirus disease 2019 (COVID‐19) J Pathol. 2020;251(3):228–248. - PMC - PubMed
    1. Klok F., Kruip M., Van der Meer N., et al. Confirmation of the high cumulative incidence of thrombotic complications in critically ill ICU patients with COVID-19: an updated analysis. Thromb Res. 2020;191:148–150. - PMC - PubMed

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