ASSOCIATION BETWEEN HEPARIN DOSE AND 6-WEEKS MORTALITY IN PATIENTS WITH COVID-19

Abstract

Background and Objectives

Severe forms of SARS-CoV-2 infections are associated with high rates of thromboembolic complications. Professional societies and expert consensus reports have recommended the use of anticoagulants for COVID-19 hospitalized patients. Our study aimed to compare the effect of therapeutic, intermediate and prophylactic doses of heparin on 6-week survival in patients hospitalized for COVID-19.

Methods
The study sample is a French cohort of COVID-19 patients, hospitalized between February 25^th and April 30^th 2020. Patients were assigned to one of 3 anticoagulation dose groups, based on the maximum dose they received for at least 3 days (prophylactic, intermediate or therapeutic). The main outcome was survival up to 42 days after hospital admission. Multivariate Cox regression models were performed to adjust analyses for confounding factors.

Results

A total of 323 patients were included. The mean age of the study sample was 71.6 ± 15 years and 56.3% were men. Treatment with the intermediate versus prophylactic dose of anticoagulation
(HR = 0.50, 95%CI = [0.26 ; 0.99], p = 0.047) and with therapeutic versus prophylactic dose (HR = 0.58 95%CI = [0.34 ; 0.98], p = 0.044) was associated with a significant reduction in 6-week mortality, after adjustment for potential confounding factors. Comparison of therapeutic versus intermediate doses showed no significant difference in survival.

Conclusions

Our results reported a significant positive effect of intermediate and therapeutic doses of heparin, compared with a prophylactic dose, on 6-week survival for hospitalized COVID-19 patients.