Background:Coronavirus disease 2019(Covid-19)remains a serious health threat worldwide.We aimed to investigate whether low molecular weight heparin(LMWH)can promote organ function recovery in moderate Covid-19 pneumon...Background:Coronavirus disease 2019(Covid-19)remains a serious health threat worldwide.We aimed to investigate whether low molecular weight heparin(LMWH)can promote organ function recovery in moderate Covid-19 pneumonia patients.Methods:We initiated an LMWH protocol in Covid-19 patients with increased D-dimer,body mass index>30 kg/m^(2) or a history of diabetes from January 18,2020 at Shanghai Public Health Clinical Center.In this retrospective study,we assigned moderate Covid-19 pneumonia patients admitted between January 18th and April 18,2020 receiving the LMWH protocol to the LMWH group.Moderate patients who met the inclusion criteria but did not receive LMWH protocol were included in the control group by 1:2 propensity score matching.General clinical information,indicators for renal function,arterial blood gas analyses,arterial blood lactic acid content(mmol/L),and coagulation indexes at 0 day,3 days,7 days,and 11 days after admission were recorded and compared between the two groups.Results:There were 41 patients in the LMWH group and 82 patients in the control group.General information in both groups were similar.Compared to the control group,the arterial blood lactic acid content(mmol/L)at day 11(1.3[1.1,1.7]vs.1.2[0.9,1.3],P=0.016)was reduced in the LMWH group.The estimated glomerular filtration rate(eGFR)in the LMWH group was higher than that in the control group at day 7(108.54[89.11,128.17]vs.116.85[103.39,133.47],P=0.039)and day 11(113.74[94.49,126.34]vs.128.31[112.75,144.12],P=0.003).The serum creatinine levels(Scr)in the LMWH group were lower than that in the control group at day 7(62.13[51.47,77.64]vs.55.49[49.50,65.75],P=0.038)and day 11(63.35[50.17,75.73]vs.51.62[44.62,61.24],P=0.005).Conclusions:LMWH treatment can reduce arterial blood lactic acid levels and improve eGFR in moderate Covid-19 pneumonia patients.Randomized controlled trials are warranted to further investigate this issue.展开更多
基金supported by grants from the second batch of emergency key scientific and technological project of Shanghai Municipal Committee of Science and Technology(Nos.20411950300,20411950301)the Clinical Research Project of Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine(No.2018CR004)to EnQiang Mao and the National Natural Science Foundation of China to Jun Huang(No.81870311)。
文摘Background:Coronavirus disease 2019(Covid-19)remains a serious health threat worldwide.We aimed to investigate whether low molecular weight heparin(LMWH)can promote organ function recovery in moderate Covid-19 pneumonia patients.Methods:We initiated an LMWH protocol in Covid-19 patients with increased D-dimer,body mass index>30 kg/m^(2) or a history of diabetes from January 18,2020 at Shanghai Public Health Clinical Center.In this retrospective study,we assigned moderate Covid-19 pneumonia patients admitted between January 18th and April 18,2020 receiving the LMWH protocol to the LMWH group.Moderate patients who met the inclusion criteria but did not receive LMWH protocol were included in the control group by 1:2 propensity score matching.General clinical information,indicators for renal function,arterial blood gas analyses,arterial blood lactic acid content(mmol/L),and coagulation indexes at 0 day,3 days,7 days,and 11 days after admission were recorded and compared between the two groups.Results:There were 41 patients in the LMWH group and 82 patients in the control group.General information in both groups were similar.Compared to the control group,the arterial blood lactic acid content(mmol/L)at day 11(1.3[1.1,1.7]vs.1.2[0.9,1.3],P=0.016)was reduced in the LMWH group.The estimated glomerular filtration rate(eGFR)in the LMWH group was higher than that in the control group at day 7(108.54[89.11,128.17]vs.116.85[103.39,133.47],P=0.039)and day 11(113.74[94.49,126.34]vs.128.31[112.75,144.12],P=0.003).The serum creatinine levels(Scr)in the LMWH group were lower than that in the control group at day 7(62.13[51.47,77.64]vs.55.49[49.50,65.75],P=0.038)and day 11(63.35[50.17,75.73]vs.51.62[44.62,61.24],P=0.005).Conclusions:LMWH treatment can reduce arterial blood lactic acid levels and improve eGFR in moderate Covid-19 pneumonia patients.Randomized controlled trials are warranted to further investigate this issue.
