The Potential of Low Molecular Weight Heparin to Mitigate Cytokine Storm in Severe COVID‐19 Patients: A Retrospective Cohort Study

• Published in: Clinical and translational science Vol. 13; no. 6; pp. 1087 - 1095
• Main Authors: Shi, Chen, Wang, Cong, Wang, Hanxiang, Yang, Chao, Cai, Fei, Zeng, Fang, Cheng, Fang, Liu, Yihui, Zhou, Taotao, Deng, Bin, Vlodavsky, Israel, Li, Jin‐Ping, Zhang, Yu
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01.11.2020; Wiley-Blackwell; John Wiley and Sons Inc
• Subjects: Adult; Aged; Aged, 80 and over; Antibodies; Anticoagulants; Blood Coagulation - drug effects; C-Reactive Protein - analysis; Cohort analysis; Coronaviridae; Coronaviruses; COVID-19; COVID-19 - complications; COVID-19 - immunology; Cytokine Release Syndrome - drug therapy; Cytokine storm; Cytokines - blood; Data collection; Degradation products; Disease transmission; Drug development; Electronic medical records; Female; Fibrinogen; Heparin; Heparin, Low-Molecular-Weight - therapeutic use; Hospitals; Humans; Inflammation; Length of Stay; Lymphocytes; Male; Middle Aged; Molecular weight; Pandemics; Patients; Pneumonia; Retrospective Studies; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Sodium; Software; Womens health; China
• ISSN: 1752-8054; 1752-8062; 1752-8062
• DOI: 10.1111/cts.12880

On March 11, 2020, the World Health Organization declared its assessment of coronavirus disease 2019 (COVID‐19) as a global pandemic. However, specific anti‐severe acute respiratory syndrome‐coronavirus 2 (SARS‐CoV‐2) drugs are still under development, and patients are managed by multiple complementary treatments. We performed a retrospective analysis to compare and evaluate the effect of low molecular weight heparin (LMWH) treatment on disease progression. For this purpose, the clinical records and laboratory indicators were extracted from electronic medical records of 42 patients with COVID‐19 (21 of whom were treated with LMWH, and 21 without LMWH) hospitalized (Union Hospital of Huazhong University of Science and Technology) from February 1 to March 15, 2020. Changes in the percentage of lymphocytes before and after LMWH treatment were significantly different from those in the control group (P = 0.011). Likewise, changes in the levels of D‐dimer and fibrinogen degradation products in the LMWH group before and after treatment were significantly different from those in the control group (P = 0.035). Remarkably, IL‐6 levels were significantly reduced after LMWH treatment (P = 0.006), indicating that, besides other beneficial properties, LMWH may exert an anti‐inflammatory effect and attenuate in part the “cytokine storm” induced by the virus. Our results support the use of LMWH as a potential therapeutic drug for the treatment of COVID‐19, paving the way for a subsequent well‐controlled clinical study.