22 November 2021

Austrian researchers have showed that heparin can reduce the duration of active infection in COVID‑19 – a potential side-effect of the treatment which may partly explain how it improves patient survival.

Dr Alice Assinger, group leader at the Institute of Vascular Biology and Thrombosis Research at the Medical University of Vienna, said: “The coagulopathy observed in COVID-19 patients is novel and differs in many respects from previously known coagulation problems.

 “COVID-19 associated coagulopathy displays characteristics that, although partially comparable with other coagulation diseases, cannot be fully explained by them.”

To try to understand the mechanism of COVID associated coagulopathy, Dr Assinger and colleagues at the Medical University of Vienna conducted a multi-centre analysis of COVID-19 patients admitted to hospital in Vienna, Linz and Innsbruck between February 2020 and September 2020.

In their analysis, they showed that COVID-19-associated coagulopathy occurs almost exclusively in patients requiring intensive care or in patients who die as a result of the virus. They confirmed that anticoagulant drugs – low-molecular-weight heparin (LMWH) or non-vitamin K anticoagulants – improve the survival of COVID-19 patients.

However, they showed that anticoagulants had no effect on D-dimer levels or immunothrombosis.

Intriguingly, the analysis showed that the period of active SARS-CoV-2 infection is reduced in patients treated with LMWH, the most commonly used anticoagulant. Active infection was reduced to 9 days with LMWH, from 13 days without the treatment.

First author David Pereyra, from MedUni Vienna's Department of General Surgery, said: “In patients who receive this drug, infection time is an average of four days shorter than in patients who are not treated with low-molecular-weight heparin. We were surprised to see that low-molecular-weight heparin may have a direct effect on coronavirus and its infectivity.”

Experimental data show that heparin can inhibit the ability of SARS-CoV-2 to bind to cells, which prevents them from being infected.

Due to the retrospective nature of this study, further research is needed to confirm the effects of LMWH on SARS-CoV-2 viral persistence and the impact on patient survival.

Source:

Pereyra D, Heber S, Schrottmaier WC, Santol J, Pirabe A, Schmuckenschlager A, Kammerer K, Ammon D, Sorz T, Fritsch F, Hayden H, Pawelka E, Krüger P, Rumpf B, Traugott MT, Glaser P, Firbas C, Schörgenhofer C, Seitz T, Karolyi M, Pabinger I, Brostjan C, Starlinger P, Weiss G, Bellmann-Weiler R, Salzer HJF, Jilma B, Zoufaly A, Assinger A.  (2021) “Low molecular weight heparin use in COVID-19 is associated with curtailed viral persistence - a retrospective multicenter observational study.”  Cardiovascular Research, doi: 10.1093/cvr/cvab308

Link: https://academic.oup.com/cardiovascres/advance-article/doi/10.1093/cvr/cvab308/6381563

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