PB0083 - Efficacy and safety of thromboprophylaxis in Covid-19 patients

Background: In covid-19 disease, microvascular thrombosis are the important factors leading to acute respiratory syndrome and death. Experts recommend anticoagulants for thromboprophylaxis in covid-19 patients. However, Anticoagulants used in these patients do not have a standard type or dosage. this study examines determine the optimal dose and type of anticoagulant for thromboprophylaxis

Aims: To evaluate efficacy and safety of the anticoagulants use for thromboprophylaxis in the covid-19 patients

Methods: This retro-prospective cohort study was conducted at Pharmongkutklao Hospital. Patients who were more than 20 years old and diagnosed covid-19 confirmed by RT-PCR for SARS-CoV2 were included between April 2021-January 2023. The primary efficacy outcomes were thromboembolism events or death from any causes, and the safety outcome was major bleeding. Risk factors for thrombosis and death were evaluated with multivariate logistic regression and multivariate Poisson regression. Survival analysis for the patients were also evaluated.

Results: A total of 201 patients were included with mean age 61.22±20.93 years. Eighty percent of patients received thromboprophylaxis with enoxaparin. Two-thirds were acutely ill patients. More than seventy percent of those with thromboprophylaxis were not vaccinated. In adjusted analysis, the use of thromboprophylaxis significantly reduced thrombosis (Odds ratio 0.16, 95%CI0.03-0.94) with no statistically significant bleeding. Duration of admission was longer in thromboprophylaxis group (Incidence rate ratio 1.48, 95%CI1.34-1.64). Patients received more than 2 vaccinations had lower rates of thrombosis (Odds ratio 0.09, 95%CI 0.009-0.89). Dyslipidemia was associated with higher rate thrombosis (Odds ratio 8.97 95%CI1.5-51.94). Elevated CRP, LDH and D-dimer were associated with an increased mortality rate.

Conclusion(s): The study shows that thromboprophylaxis with enoxaparin results in a lower thrombosis rate without causing any fatal bleeding. Furthermore, CRP, LDH, and D-dimer can be used to predict the mortality rate in patients with covid-19. This limitation of this study is a relatively small simple which required a larger sample for its use.