Effect of Anticoagulants on the Survival Rate in Critically Ill COVID-19 Patients

Abstract

Background: The World Health Organization (WHO) declared Coronavirus disease 2019 (COVID-19), as a pandemic in January 2020. The morbidity and mortality associated with the disease are enormous COVID-19, with a multi-systemic pathology, exhibits thrombosis as a common manifestation. Disseminated intravascular coagulation (DIC) and thrombotic lesions have been reported in >70% and >30% of patients, respectively, who have died due to the COVID-19 and therefore, heparin is included in the treatment of moderate to severe cases. This retrospective study was undertaken to check the effectiveness of prophylactic therapy with heparin at reducing mortality in critically ill COVID-19 patients. Methodology: The study included retrospective data from case records of 169 critically ill COVID-19 patients with or without comorbidities and an anticoagulant regimen. The data were thoroughly studied for demographic profile, comorbidities, type and dosage of anticoagulants, length of intensive care unit stay, and mortality rates. Results: The male to female ratio of the study subjects was 125/44 (76%/24%). Patients with comorbidities were critically ill as compared to those with none (140/29), and diabetes mellitus was the most common comorbidity, found in 99 patients. Mortality rate was significantly higher in patients who had not received any anticoagulant (p = 0.015) and in patients who had received unfractionated heparin (p =0.036) as compared to those who received low molecular weight heparin (LMWH). Conclusion: The prophylactic administration of heparin improves the survival rate of the critically ill covid 19 patients is more when compared with the patients who do not receive heparin. LMWH is very effective in reducing thrombotic complications and mortality in critically ill COVID-19 patients.