Fondaparinux Use in Patients With COVID-19: A Preliminary Multicenter Real-World Experience.

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Abstrakt

Tytuł:: Fondaparinux Use in Patients With COVID-19: A Preliminary Multicenter Real-World Experience.
Autorzy:: Russo V; Department of Translational Medical Sciences, University of Campania 'Luigi Vanvitelli'-Monaldi Hospital, Naples, Italy.
Cardillo G; Advanced Biochemistry Unit Medylab Institute, Lusciano (CE), Italy.
Viggiano GV; Emergency Medicine Unit, Marazzini Hospital, Modena, Italy.
Mangiacapra S; Internal Medicine Unit, Moscati Hospital, Avellino, Italy.
Cavalli A; Internal Medicine Unit, Frangipane Hospital, Ariano Irpino, Italy.
Fontanella A; Internal Medicine Unit, Fatebenefratelli Hospital, Naples, Italy; and.
Agrusta F; Emergency Medicine Unit, Marazzini Hospital, Modena, Italy.
Bellizzi A; Internal Medicine Unit, Frangipane Hospital, Ariano Irpino, Italy.
Amitrano M; Internal Medicine Unit, Moscati Hospital, Avellino, Italy.
Iannuzzo M; Internal Medicine Unit, Fatebenefratelli Hospital, Naples, Italy; and.
Sacco C; Thrombosis and Hemorragic Center, Humanitas Research Hospital and University, Rozzano, Italy.
Lodigiani C; Thrombosis and Hemorragic Center, Humanitas Research Hospital and University, Rozzano, Italy.
Di Micco P; Internal Medicine Unit, Fatebenefratelli Hospital, Naples, Italy; and.
Źródło:: Journal of cardiovascular pharmacology [J Cardiovasc Pharmacol] 2020 Oct; Vol. 76 (4), pp. 369-371.
Typ publikacji:: Comparative Study; Journal Article; Multicenter Study
Język:: English
Imprint Name(s):: Publication: Hagerstown, MD : Lippincott Williams & Wilkins
Original Publication: New York, Raven Press.
MeSH Terms:: Antithrombins/*therapeutic use
Coronavirus Infections/*complications
Coronavirus Infections/*drug therapy
Factor Xa Inhibitors/*therapeutic use
Fondaparinux/*therapeutic use
Pneumonia, Viral/*complications
Pneumonia, Viral/*drug therapy
Venous Thrombosis/*etiology
Venous Thrombosis/*prevention & control
Aged ; Anticoagulants/adverse effects ; Anticoagulants/therapeutic use ; Antithrombins/adverse effects ; COVID-19 ; Enoxaparin/adverse effects ; Enoxaparin/therapeutic use ; Factor Xa Inhibitors/adverse effects ; Female ; Fondaparinux/adverse effects ; Hemorrhage/chemically induced ; Hospital Mortality ; Humans ; Incidence ; Male ; Middle Aged ; Pandemics ; Pulmonary Embolism/complications ; Retrospective Studies ; Venous Thromboembolism/epidemiology ; Venous Thromboembolism/prevention & control ; Venous Thrombosis/epidemiology
References:: Russo V, Rago A, Carbone A, et al. Atrial fibrillation in COVID-19: from epidemiological association to pharmacological implications [published online ahead of print, 2020 May 18]. J Cardiovasc Pharmacol. 2020;76:138–145.
Di Micco P, Russo V, Carannante N, et al. Clotting factors in COVID-19: epidemiological association and prognostic values in different clinical presentations in an Italian cohort. J Clin Med. 2020;9:1371.
Tang N, Bai H, Chen X, et al. Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy. J Thromb Haemost. 2020;18:1094–1099.
Middeldorp S, Coppens M, van Haaps TF, et al. Incidence of venous thromboembolism in hospitalized patients with COVID-19. J Thromb Haemost. 2020;18:1995–2002.
Kumar A, Talwar A, Farley JF, et al. Fondaparinux sodium compared with low molecular-weight heparins for Perioperative surgical thromboprophylaxis: a systematic review and meta-analysis. J Am Heart Assoc. 2019;8:e012184.
Available at: https://www.who.int/publications-detail/clinical-management-of-severe-acute-respiratory-infection-when-novel-coronavirus-(ncov)-infection-is-suspected. Accessed August 25, 2020.
Barbar S, Noventa F, Rossetto V, et al. A risk assessment model for the identification of hospitalized medical patients at risk for venous thromboembolism: the Padua Prediction Score. J Thromb Haemost. 2010;8:2450–2457.
Kaatz S, Ahmad D, Spyropoulos AC, et al. Definition of clinically relevant non-major bleeding in studies of anticoagulants in atrial fibrillation and venous thromboembolic disease in non-surgical patients: communication from the SSC of the ISTH. J Thromb Haemost. 2015;13:2119–2126.
ARDS Definition Task Force, Ranieri VM, Rubenfeld GD, Thompson BT, et al. Acute respiratory distress syndrome: the Berlin Definition. JAMA. 2012;307:2526–2533.
Russo V, Bottino R, Carbone A, et al. COVID-19 and heart: from clinical features to pharmacological implications. J Clin Med. 2020;9:1944.
Russo V, Di Maio M, Attena E, et al. Clinical impact of pre-admission antithrombotic therapy in hospitalized patients with COVID-19: a multicenter observational study [published online ahead of print, 2020 May 29]. Pharmacol Res. 2020;159:104965.
Kahn SR, Lim W, Dunn AS, et al. Prevention of VTE in nonsurgical patients: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of chest Physicians Evidence-Based clinical practice Guidelines. Chest. 2012;141(2 suppl):e195S–e226S.
Klok FA. Confirmation of the high cumulative incidence of thrombotic complications in critically ill ICU patients with COVID-19: an updated analysis. Thromb Res. 2020;191:148–150.
Cui S, Chen S, Li X, et al. Prevalence of venous thromboembolism in patients with severe novel coronavirus pneumonia. J Thromb Haemost. 2020;18:1421–1424.
Zhang Z, Zhai Z, Yang Y, et al. Diabetes mellitus is associated with increased bleeding in pulmonary embolism receiving conventional anticoagulant therapy: findings from a “real-world” study. J Thromb Thrombolysis. 2017;43:540–549.
Substance Nomenclature:: 0 (Anticoagulants)
0 (Antithrombins)
0 (Enoxaparin)
0 (Factor Xa Inhibitors)
J177FOW5JL (Fondaparinux)
Entry Date(s):: Date Created: 20201007 Date Completed: 20201015 Latest Revision: 20210208
Update Code:: 20240105
DOI:: 10.1097/FJC.0000000000000893
PMID:: 33027192
: Czasopismo naukowe

The use of heparin has been shown to decrease the mortality in hospitalized patients with severe COVID-19. The aim of our study was to evaluate the clinical impact of venous thromboembolism prophylaxis with fondaparinux versus enoxaparin among 100 hospitalized COVID-19 patients. The incidence of pulmonary embolism, deep venous thrombosis, major bleeding (MB), clinically relevant non-MB, acute respiratory distress syndrome, and in-hospital mortality was compared between patients on fondaparinux versus enoxaparin therapy. The 2 groups were homogeneous for demographic, laboratory, and clinical characteristics. In a median follow-up of 28 (IQR: 12-45) days, no statistically significant difference in venous thromboembolism (14.5% vs. 5.3%; P = 0.20), MB and clinically relevant non-MB (3.2% vs. 5.3%, P = 0.76), ARDS (17.7% vs. 15.8%; P = 0.83), and in-hospital mortality (9.7% vs. 10.5%; P = 0.97) has been shown between the enoxaparin group versus the fondaparinux group. Our preliminary results support the hypothesis of a safe and effective use of fondaparinux among patients with COVID-19 hospitalized in internal medicine units.

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