Use of heparin in patients with severe COVID-19: What is the evidence?

Vitória Ribeiro Dantas Marinho,Camila Vilar Oliveira Villarim,Irami Araújo-Filho,Diego Maia Diogenes Rabelo Caldas,Amália Cinthia Meneses Rêgo,André Luiz Costa E Silva,Laura Cristina Costa E Silva,Irami Araújo-Neto

doi:10.33448/rsd-v10i6.15820

Vitória Ribeiro Dantas Marinho, Camila Vilar Oliveira Villarim + Show 6 more

Open Access

https://doi.org/10.33448/rsd-v10i6.15820

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Abstract

The rapid spread of coronavirus disease (COVID-19) worldwide urges the need for studies on the illness and its management. The COVID-19 infection leads to hypercoagulation due to inflammatory cytokine release and D-dimer increase in critically ill patients, resulting in pulmonary thromboembolism (PE) and venous thromboembolism (VTE) evolving to sepsis and death. The study evaluated the currently existing evidence on heparin administration in patients with severe COVID-19. An integrative literature review was done by searching for scientific studies in the PubMed, Scopus, Embase, and Web of Science databases. The analyzed studies showed that heparin use in critically ill patients could efficiently prevent thrombotic events and reduce the exacerbated inflammatory process. However, further investigation on the effect on patients is still needed. The use of heparin in critically ill COVID-19 patients has been prescribed increasingly by doctors. But its use has not yet had its outcomes well established in the literature. Therefore, deeper investigations and new research development are needed to clarify potential beneficial effects.

Highlights

In late 2019, in Wuhan, China, an acute respiratory disease caused by the SARS-CoV-2 virus, the coronavirus disease (COVID-19), emerged
The PubMed, Scopus, Embase, and Web of Science databases were used, by the keywords COVID-19, heparin, SARS-CoV-2, blood coagulation, thrombosis, and anticoagulants, in search of research published in Spanish, English, and Portuguese, in the last year
Current insights talk about the virus's ability to trigger an inflammatory cascade involving cytokines (Marietta et al, 2020; Boccia et al, 2020; Riveros et al, 2020) combined with a state of hypercoagulation (Marietta et al, 2020; Boccia et al, 2020; Lindahl, & Li, 2020; Riveros et al, 2020; Schmoch et al, 2021), especially in critically ill patients admitted to the intensive care unit (ICU) (Riveros et al, 2020; Schmoch et al, 2021)

Summary

Introduction

In late 2019, in Wuhan, China, an acute respiratory disease caused by the SARS-CoV-2 virus, the coronavirus disease (COVID-19), emerged. In late 2019, in Wuhan, China, an acute respiratory disease caused by the SARS-CoV-2 virus, the coronavirus disease Due to its potent virulence, the severe acquired coronavirus respiratory syndrome spread rapidly in several countries, becoming a world pandemic declared by the World Health Organization in March 2020 (Marietta et al, 2020; Bocchese et al, 2020; Dantas et al, 2021; Marinho et al, 2021). Most of the infected patients developed mild manifestations and a good prognosis. Some had severe forms of the disease and died from multiple systemic complications (Marietta et al, 2020). The disease affects the most diverse organ systems and can manifest varied clinical conditions (Góes et al., 2020)

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