INTRODUCTION: A hypercoagulable condition was described in patients with coronavirus disease 2019 (COVID-19) and proposed as a possible pathogenic mechanism contributing to disease progression and lethality.AIM: We evaluated if in-hospital administration of heparin improved survival in a large cohort of Italian COVID-19 patients.METHODS: In a retrospective observational study, 2,574 unselected patients hospitalized in 30 clinical centers in Italy from February 19, 2020 to June 5, 2020 with laboratory-confirmed severe acute respiratory syndrome coronavirus-2 infection were analyzed. The primary endpoint in a time-to event analysis was in-hospital death, comparing patients who received heparin (low-molecular-weight heparin [LMWH] or unfractionated heparin [UFH]) with patients who did not. We used multivariable Cox proportional-hazards regression models with inverse probability for treatment weighting by propensity scores.RESULTS: Out of 2,574 COVID-19 patients, 70.1% received heparin. LMWH was largely the most used formulation (99.5%). Death rates for patients receiving heparin or not were 7.4 and 14.0 per 1,000 person-days, respectively. After adjustment for propensity scores, we found a 40% lower risk of death in patients receiving heparin (hazard ratio=0.60; 95% confidence interval: 0.49-0.74; E-value=2.04). This association was particularly evident in patients with a higher severity of disease or strong coagulation activation.CONCLUSION: In-hospital heparin treatment was associated with a lower mortality, particularly in severely ill COVID-19 patients and in those with strong coagulation activation. The results from randomized clinical trials are eagerly awaited to provide clear-cut recommendations.
Di Castelnuovo, A., Costanzo, S., Antinori, A., Berselli, N., Blandi, L., Bonaccio, M., et al. (2021). Heparin in COVID-19 Patients Is Associated with Reduced In-Hospital Mortality: the Multicenter Italian CORIST Study. THROMBOSIS AND HAEMOSTASIS.
|Citazione:||Di Castelnuovo, A., Costanzo, S., Antinori, A., Berselli, N., Blandi, L., Bonaccio, M., et al. (2021). Heparin in COVID-19 Patients Is Associated with Reduced In-Hospital Mortality: the Multicenter Italian CORIST Study. THROMBOSIS AND HAEMOSTASIS.|
|Tipo:||Articolo in rivista - Articolo scientifico|
|Carattere della pubblicazione:||Scientifica|
|Presenza di un coautore afferente ad Istituzioni straniere:||No|
|Titolo:||Heparin in COVID-19 Patients Is Associated with Reduced In-Hospital Mortality: the Multicenter Italian CORIST Study|
|Autori:||Di Castelnuovo, A; Costanzo, S; Antinori, A; Berselli, N; Blandi, L; Bonaccio, M; Cauda, R; Guaraldi, G; Menicanti, L; Mennuni, M; Parruti, G; Patti, G; Santilli, F; Signorelli, C; Vergori, A; Abete, P; Ageno, W; Agodi, A; Agostoni, P; Aiello, L; Al Moghazi, S; Arboretti, R; Astuto, M; Aucella, F; Barbieri, G; Bartoloni, A; Bonfanti, P; Cacciatore, F; Caiano, L; Carrozzi, L; Cascio, A; Ciccullo, A; Cingolani, A; Cipollone, F; Colomba, C; Colombo, C; Crosta, F; Danzi, G; D'Ardes, D; de Gaetano Donati, K; Di Gennaro, F; Di Tano, G; D'Offizi, G; Fantoni, M; Fusco, F; Gentile, I; Gianfagna, F; Grandone, E; Graziani, E; Grisafi, L; Guarnieri, G; Larizza, G; Leone, A; Maccagni, G; Madaro, F; Maitan, S; Mancarella, S; Mapelli, M; Maragna, R; Marcucci, R; Maresca, G; Marongiu, S; Marotta, C; Marra, L; Mastroianni, F; Mazzitelli, M; Mengozzi, A; Menichetti, F; Meschiari, M; Milic, J; Minutolo, F; Molena, B; Montineri, A; Mussini, C; Musso, M; Niola, D; Odone, A; Olivieri, M; Palimodde, A; Parisi, R; Pasi, E; Pesavento, R; Petri, F; Pinchera, B; Poletti, V; Ravaglia, C; Rognoni, A; Rossato, M; Rossi, M; Sangiovanni, V; Sanrocco, C; Scorzolini, L; Sgariglia, R; Simeone, P; Taddei, E; Torti, C; Vettor, R; Vianello, A; Vinceti, M; Virano, A; Vocciante, L; De Caterina, R; Iacoviello, L|
|Data di pubblicazione:||2021|
|Rivista:||THROMBOSIS AND HAEMOSTASIS|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1055/a-1347-6070|
|Appare nelle tipologie:||01 - Articolo su rivista|