Low Molecular Weight Heparin Doses and Ventilator Airway Necessity in the COVID-19 Patients: Systematic Review and Meta-analysis

Yuyun Yueniwati; Mokhamad Fahmi Rizki Syaban; Athaya Febriantyo Purnomo; Edwin Kinesya; Yusuf Mannagalli; Erwin Alexander Pasaribu; Nurul Cholifah Lutfiana; Adilla Shafryantyo Purnomo

doi:10.3889/oamjms.2022.8701

Authors

Yuyun Yueniwati Department of Radiology, Faculty of Medicine, Universitas Brawijaya, Saiful Anwar Hospital Malang, Malang, Indonesia https://orcid.org/0000-0001-9932-2015
Mokhamad Fahmi Rizki Syaban Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia https://orcid.org/0000-0003-4287-2379
Athaya Febriantyo Purnomo Department of Urology, Faculty of Medicine, Universitas Brawijaya, Saiful Anwar Hospital Malang, Malang, Indonesia https://orcid.org/0000-0002-4710-4486
Edwin Kinesya Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia https://orcid.org/0000-0002-5210-9089
Yusuf Mannagalli Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia https://orcid.org/0000-0003-1308-519X
Erwin Alexander Pasaribu Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia https://orcid.org/0000-0003-4675-0117
Nurul Cholifah Lutfiana Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia https://orcid.org/0000-0001-9876-0099
Adilla Shafryantyo Purnomo Faculty of Medicine, Universitas Sebelas Maret, Moewardi General Hospital, Surakarta, Indonesia https://orcid.org/0000-0001-8833-3739

DOI:

https://doi.org/10.3889/oamjms.2022.8701

Keywords:

Anticoagulants, COVID-19, Mechanical ventilation, Mortality, Bleeding

Abstract

BACKGROUND: Anticoagulant therapy is recommendation for COVID-19 infection. However, the mechanical ventilation needed for COVID-19 is still high.

AIM: The aim of the study was to determine comparison therapeutic and prophylactic dose LMWH for mechanical necessity in COVID-19 infection.

METHODS: A systematic literature search articles online from studies published between 2020 and 2021 that met our inclusion criteria and were retrieved from scientific databases such as Cochrane, ProQuest, and PubMed. The primary measure was a composite bad outcome, which included mechanical ventilation, mortality. and bleeding risk.

RESULTS: There were 3432 patients from seven study included in this meta-analysis for necessity of mechanical ventilation in COVID-19 patients that used prophylactic and therapeutic anticoagulants. Prophylactic dose of anticoagulant showed no difference for the need for mechanical ventilation necessity for COVID-19 patients (RR = 0.54; 95% CI = 0.20–1.48; p = 0.23). However, prophylactic anticoagulant showed more safe for bleeding incidence (RR = 0.27; 95% CI = 0.18–0.39; p = <0.00001) and reduce mortality (RR = 0.52; 95% CI = 0.46-0.58; p = <0.00001).

CONCLUSION: LMWH anticoagulant dose not associated with reduce mechanical ventilation necessity but prophylactic dose prefers rather than therapeutic dose for reduce mortality and risk of bleeding.

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