Low molecular weight heparin is associated with better outcomes than unfractionated heparin for thromboprophylaxis in hospitalized COVID-19 patients: a meta-analysis.

Mochamad Yusuf Alsagaff, Eka Prasetya Budi Mulia, Irma Maghfirah, Yusuf Azmi, Dita Aulia Rachmi, Alqi Yutha, Luqman Hakim Andira, Bambang Pujo Semedi

European heart journal. Quality of care & clinical outcomes 2022 Nov 17

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This study aimed to compare the outcomes of the administration of LMWH and UFH in hospitalized COVID-19 patients. We systematically searched several databases and included observational studies or clinical trials that compared the outcomes of the administration of LMWH and UFH in hospitalized COVID-19 patients. A total of nine studies comprising 9637 patients were included. Metanalysis showed that LMWH administration was associated with a lower in-hospital mortality and 28/30-day mortality compared with UFH administration {[relative risk (RR) 0.44; 95% confidence interval (95% CI) 0.32-0.61; I2: 87.9%] and (RR 0.45; 95% CI 0.24-0.86; I2: 78.4%), respectively}. Patient with LMWH had shorter duration of hospital and ICU length of stay compared with UFH {[weighted mean difference (WMD) -2.20; 95% CI -3.01 to -1.40; I2:0%] and (WMD -1.41; 95% CI -2.20 to -0.63; I2: 0%), respectively}. The risk of ICU admission or mechanical ventilation was lower in patients who received LMWH than in those who received UFH (RR 0.67; 95% CI 0.55-0.81; I2: 67.3%). However, there was no difference in the incidence of bleeding with LMWH compared with UFH (RR 0.27; 95% CI 0.07-1.01; I2: 64.6%). Our meta-analysis showed that administration of LMWH was associated with better outcomes compared with UFH in hospitalized COVID-19 patients. Prospective cohorts and RCTs are urgently needed to explore the definitive effect of LMWH to provide direct high-certainty evidence. PROSPERO registration number: CRD42021271977. © The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology.

Citation

Mochamad Yusuf Alsagaff, Eka Prasetya Budi Mulia, Irma Maghfirah, Yusuf Azmi, Dita Aulia Rachmi, Alqi Yutha, Luqman Hakim Andira, Bambang Pujo Semedi. Low molecular weight heparin is associated with better outcomes than unfractionated heparin for thromboprophylaxis in hospitalized COVID-19 patients: a meta-analysis. European heart journal. Quality of care & clinical outcomes. 2022 Nov 17;8(8):909-918