VPB0615 - Therapeutic Dose of Enoxaparin Associated with a Better Outcome for COVID-19 Hospitalized Patients

Background: Coronavirus disease (COVID-19) is associated with thromboinflammation that correlates with disease severity and mortality.

Aims: To identify biomarkers of coagulation and inflammation or therapeutic issues that are associated with the clinical outcome of COVID-19 patients.

Methods: A single-center retrospective study was performed of adult COVID-19 positive admitted to Centro Hospitalar Universitário do Porto (CHUPorto) due to COVID 19 infection or acquired the infection during hospitalization from October to November 2020 (SARS COV-2 infection second wave). Two dependent variables were defined: hospitalization outcome (dead or alive) and oxygen supplementation (needed or not). Data were collected by consulting patients' clinical files.

Results: Of 492 adults with SARS-COV-2 infection, 53.9% were male. The sample had a mean age of 70.44 years (SD = 15.36). The majority (87%) was symptomatic and 76.2% required oxygen supplementation. Regarding treatment, 89.2% received enoxaparin, mostly (68.5%) prophylactically. By the end of November, 12.8% of the sample (n = 63) had died; this number increased to 20.1% (n = 99) at the end of March 2021. Those who survived Covid 19 had lower plasmatic levels of CRP (C-reactive protein) and D-dimer (table 1).
Fibrinogen and CRP plasmatic levels were higher in patients who required oxygen supplementation in comparison to those who did not.
The outcome dead or alive correlates with D-dimer, oxygen supplementation, and enoxaparin regime; oxygen supplementation correlates with CRP, ferritin, fibrinogen, D-dimer, hospitalization time, enoxaparin, enoxaparin regime. Symptomatic patients have higher values of CRP and fibrinogen in comparison to asymptomatic patients.
Concerning therapeutic with enoxaparin [χ2(1) = 7.079; p = 0.008; Φ = -0.120], those who died mostly received enoxaparin (81.8%) and in prophylactic regime (58%) [χ2(1) = 19.559; p < 0.001; Φ = -0.211].

Conclusion(s): Inflammation and thrombosis are associated with a poorer clinical outcome and therapeutic dose of enoxaparin could be protective in COVID-19 hospitalized patients.