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Heparin and SARS-CoV-2: Multiple Pathophysiological Links
Authors:Pierpaolo Di Micco  Egidio Imbalzano  Vincenzo Russo  Emilio Attena  Vincenzo Mandaliti  Luana Orlando  Maurizio Lombardi  Gianluca Di Micco  Giuseppe Camporese  Saverio Annunziata  Gaetano Piccinocchi  Walter Pacelli  Michele Del Guercio
Abstract:
Low molecular weight heparin, enoxaparin, has been one of most used drugs to fight the SARS-CoV-2 pandemic. Pharmacological properties of heparin recognize its specific ability, as with other oligosaccharides and glycosaminoglycan, to bind several types of viruses during their pass through the extracellular matrix of the respiratory tract, as well as its anticoagulant activity to prevent venous thromboembolism. Antithrombotic actions of enoxaparin have been testified both for inpatients with COVID-19 in regular ward and for inpatients in Intensive Care Units (ICUs). Prophylactic doses seem to be able to prevent venous thromboembolism (VTE) in inpatients in the regular ward, while intermediate or therapeutic doses have been frequently adopted for inpatients with COVID-19 in ICU. On the other hand, although we reported several useful actions of heparin for inpatients with COVID-19, an increased rate of bleeding has been recorded, and it may be related to several conditions such as underlying diseases with increased risks of bleeding, increased doses or prolonged administration of heparin, personal trend to bleed, and so on.
Keywords:COVID-19   heparins   low molecular weight heparin   fondaparinux   bleedings   venous thromboembolism
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