HEPARIN


DrugBank ID: db01109
DrugCentral: heparin
Synonymous :eparina | heparina | heparine | heparinic acid | heparinum | unfractionated heparin



Drug Sentece Context


Table 1. Analysis of context sentence of heparin gene in 71 abstracts.

pmid sentence
32196410 Combined with the published literature, the potential pathogenesis of COVID-19 is inferred, and the treatment recommendations for giving high-doses intravenous immunoglobulin and low-molecular-weight heparin anticoagulant therapy to severe type patients are proposed.
32208840 Furthermore, he observes the significant abnormality of coagulation function and proposes that the early intravenous immunoglobulin and low molecular weight heparin anticoagulation therapy are very important.
32220112 A relatively high mortality of severe coronavirus disease 2019 (COVID-19) is worrying, the application of heparin in COVID-19 has been recommended by some expert consensus due to the risk of disseminated intravascular coagulation and venous thromboembolism. […] The 28-day mortality between heparin users and nonusers were compared, also in different risk of coagulopaphy which was stratified by the sepsis-induced coagulopathy (SIC) score or D-dimer result. […] There were 449 patients with severe COVID-19 enrolled into the study, 99 of them received heparin (mainly with low molecular weight heparin, LMWH) for 7 days or longer. […] No difference on 28-day mortality was found between heparin users and nonusers (30.3% vs 29.7%, P=0.910). […] But the 28-day mortality of heparin users were lower than nonusers In patients with SIC score ≥4 (40.0% vs 64.2%, P=0.029), or D-dimer > 6 fold of upper limit of normal (32.8% vs 52.4%, P=0.017).
32220276 D-dimer and FDP levels increased progressively when COVID-2019 exacerbated, and 4 patients were diagnosed with definite disseminated intravascular coagulation (DIC). 6 patients received low molecular weight heparin (LMWH) treatment, after which their D-dimer and FDP decreased, but there was no significant improvement in clinical symptoms. 5 patients died finally and the median time from acro-ischemia to death was 12 days. Conclusions: The existence of hypercoagulation status in critical COVID-2019 patients should be monitored closely, and anticoagulation therapy can be considered in selected patients.
32239799 Coagulopathy in corona virus infection has been shown to be associated with high mortality with high D-dimers being a particularly important marker for the coagulopathy.1 In the latest paper from the same group, the use of anticoagulant therapy with heparin was shown to decrease mortality as well. 2 This is especially so in patients i) who have met the sepsis induced coagulopathy (SIC) criteria ≥4 (40.0% vs 64.2%, P=0.029) compared to those with SIC score <4 (29.0% vs 22.6%, P=0.419).or ii) with markedly elevated D-dimer (greater than six-fold at the upper limit of normal).
32246317 The 28-day mortality of heparin users were lower than nonusers In COVID group with D-dimer > 3.0 μg/mL (32.8% vs.
32282949 COVID-19 infected patients whatever hospitalized or ambulatory are at high risk for VTE and an early and prolonged pharmacological thromboprophylaxis with low molecular weight heparin is highly recommended.
32294289 In this retrospective analysis, conducted at the Tongji Hospital of Wuhan, China, it is reported that heparin treatment reduces mortality in subjects affected by severe COVID-19 who have “sepsis-induced coagulopathy”. […] The Authors of this study also reported that, among subjects not treated with heparin, mortality raised according with D-dimer levels. […] Of note, patients that received heparin in this study were mostly treated with enoxaparin, at the thromboprophylactic dose of 40-60 mg/day, for at least 7 days.
32297089 In consideration of the pharmacological characteristics of oral anticoagulant drugs, the multiple pharmacological interactions due to the treatment of acute disease and the possible necessity of mechanical ventilation with hospitalization in intensive-care units, we suggest replacing oral anticoagulant therapies (VKA and DOAC) with parenteral heparin to avoid the risk of over/under treatment.
32302448 Ten patients were followed in the subsequent 7 days, after increasing the dose of low molecular weight heparin, antithrombin levels correction, and clopidogrel in selected cases.
32302462 While we agree that this interim guidance addresses important considerations for monitoring the disease process, we believe that the proposed treatment strategy of prophylactic low molecular weight heparin (LMWH) to treat severe COVID-19 coagulopathy is an unconvincing strategy. […] We address this concern with the existing data on the severe hypercoagulable state of COVID-19 victims and advocate for consideration of systemic anticoagulation with unfractionated heparin to prevent life threatening micro- and macrovascular thrombosis to mitigate their associated consequences, up to and including progression of respiratory and organ failure.
32329246 Prophylaxis treatment of COVID-19 patients with low molecular weight heparin (LMWH) is important to limit coagulopathy.
32330308 Importantly however, Caucasian COVID19 patients on low molecular weight heparin thromboprophylaxis rarely develop overt disseminated intravascular coagulation (DIC).
32335456 We suppose that host cell proteases including furin (as expressed highly in lungs), factor Xa and cathepsin are possible targets to decrease viral burden, therefore unfractioned heparin and low molecular weight heparin-LMWH (specifically dalteparin and tinzaparin for their anti inflammatory action) can be potential inhibitors of multiple endoproteases involved in virus infectivity. […] Our hypothesis needs to be tested in in vitro and clinical studies, however as we are in an urgent situation as the burden of SARS-CoV2 is increasing all around the world, we recommend the usage of unfractioned heparin or LMWH in intensive care unit (ICU) and non-ICU hospitalized patients with the risk-benefit judgement of the clinician.
32345864 Thoracic computed tomography (CT) and oropharyngeal swabs confirmed that they were positive for COVID-19, requiring hospitalization and prophylaxis with low-molecular-weight heparin.
32360432 Antiretroviral therapy and prophylactic low molecular weight heparin treatment were initiated.
32360679 Although successful revascularization was not significantly associated with the postoperative use of intravenous heparin (64.7% vs 83.3%; P = .622), no patient who had received intravenous heparin required reintervention. […] The use of continuous postoperative systemic heparin infusion was significantly associated with survival (0% vs 57.1%; P = .042). […] The use of prolonged systemic heparin might improve surgical treatment efficacy, limb salvage, and overall survival.
32364677 A liver and kidney transplant patient with SARS-CoV-2 pneumonia without respiratory failure was treated in a clinical multimodal strategy consisting of symptomatic support therapy, immunosuppression reduction, use of anti-coronavirus drugs and heparin leading to a progressive improvement of patient symptoms till discharge.
32397399 Using propensity scores, the 21 patients who received TCZ were matched to 21 patients who received SOC (a combination of hydroxychloroquine, azithromycin and prophylactic dose of low weight heparin).
32399449 Deep vein thrombosis and pulmonary embolism can occur in patients with COVID-19 pneumonia.Low-molecular-weight heparin prophylaxis does not decrease the risk of venous thromboembolism (VTE) in COVID-19 pneumonia.In the presence of clinical signs and/or suspicion of VTE, compression ultrasound and echocardiography should be always performed, irrespective of disease stage.
32399456 A 52-year-old patient with SARS-CoV-2 was diagnosed with interstitial pneumonia and treated with darunavir/ritonavir, hydroxychloroquine, azithromycin and low molecular weight heparin (LMWH).
32408391 A recent paper by Tang et al. [2] in this journal reported that heparin treatment reduced mortality of COVID-19 patients with elevated D-dimer; similar preliminary results have been reported elsewhere [3].
32415902 Recent studies have also reported and advised on the use of prophylactic Low Molecular Weight Heparin (LMWH) in COVID-19 patients, to prevent the severe outcomes associated with thromboembolic complications.
32418066 The correct article title is “Venous Thromboembolism and Heparin Use in COVID-19 Patients: Juggling between Pragmatic Choices, Suggestions of Medical Societies and the Lack of Guidelines”.
32423903 We describe three cases of thromboembolism refractory to heparin treatment, the incidence of VTE in an inpatient cohort, and a case-control study to identify risk factors associated with VTE.
32425013 Anticoagulants, mainly low-molecular-weight heparin (LMWH), should be tailored in patients meeting sepsis induced coagulopathy (SIC) criteria or with markedly elevated D-dimer.
32426897 Recent reports published in Thrombosis and Haemostasis show that treatment with low-molecular weight heparin (LMWH) decreases mortality in critically ill patients with sepsis-induced hypercoagulation, and thus argue for prophylactic administration of the anticoagulant. […] In addition, the authors point to non-anticoagulant activities of heparin, in particular anti-inflammatory effects with potential to prevent deterioration of the disease. […] We would like to use this opportunity to clarify the biochemical background of the diverse activities of heparin, and further, how this information may be exploited to generate more efficient treatment of the viral infection. […] Mechanisms to consider relate to the functional roles of proteins interacting with heparan sulfate (HS), a polysaccharide closely related to heparin.
32445030 Sixthly, whenever possible, oral anticoagulation should be converted to parental heparin.
32445064 In a cohort of 69 intensive care unit (ICU) patients we investigated for evidence of heparin resistance in those that have received therapeutic anticoagulation. 15 of the patients have received therapeutic anticoagulation with either unfractionated heparin (UFH) or low molecular weight heparin (LMWH), of which full information was available on 14 patients. […] Heparin resistance to UFH was documented in 8/10 (80%) patients and sub-optimal peak anti-Xa following therapeutic LMWH in 5/5 (100%) patients where this was measured (some patients received both anticoagulants sequentially). […] In conclusion, we have found evidence of heparin resistance in critically unwell COVID-19 patients.
32447121 Intra-arterial fibrinolysis and intravenous heparin infusion did not lead to complete recanalization of the tibial arteries, which were successfully treated by surgical embolectomy.
32447934 Low molecular weight heparin (LMWH) was administrated in 6 patients, which reduced D-dimer and FDP rather than improved clinical symptoms.
32450344 All controls were receiving prophylactic or therapeutic dose heparin, according to local standard operating procedures.
32451823 D-dimer level-guided aggressive thromboprophylaxis regimens using higher doses of heparin should be evaluated in prospective studies.
32459790 Also, four children received heparin.
32463186 Two of the cases occurred despite early institution of standard dosage of low molecular weight heparin thromboprophylaxis, and in one case, pulmonary embolism was diagnosed during the convalescent phase of an otherwise benign COVID-19 disease course.
32467443 In all hospitalized patients, thromboprophylaxis using low-molecular-weight heparin is currently recommended.
32470198 I thank Lindahl and Li for their thoughtful comments on the non-anticoagulant properties of heparin.1 Heightened awareness of hypercoagulability has made heparin part and parcel of the COVID-19 management algorithms. […] In addition, reports of prophylactic anticoagulation failure have triggered several trials where escalated doses of heparin are compared with standard doses with the aim of preventing thrombotic complications. […] At this juncture, we do need to consider where do the non-anticoagulant properties of heparin fit in the COVID-19 clinical context?
32471650 Six out of 7 patients were treated with unfractionated or low molecular weight heparin with clinical benefit within few days; one patient needed systemic thrombolysis (death from hemorrhagic complication).
32473596 In this article by the Global COVID-19 Thrombosis Collaborative Group, we describe novel dosing approaches for commonly used antithrombotic agents (especially heparin-based regimens) and the potential use of less widely used antithrombotic drugs in the absence of confirmed thrombosis.
32476080 This study investigates the association between the treatment with heparin and mortality in patients admitted with Covid-19. […] The following variables were extracted for this study: age, gender, temperature, and saturation of oxygen on admission, treatment with heparin, hydroxychloroquine, azithromycin, steroids, tocilizumab, a combination of lopinavir with ritonavir, and oseltamivir, together with data on mortality. […] Heparin had been used in 1734 patients. […] Heparin was associated with lower mortality when the model was adjusted for age and gender, with OR (95% CI) 0.55 (0.37-0.82) p = 0.003. […] The association between heparin and lower mortality observed in this study can be acknowledged by clinicians in hospitals and in the community. […] Randomized controlled trials to assess the causal effects of heparin in different therapeutic regimes are required.
32476308 A proper combination of antiviral agents, immune modulators such as prednisolone, and anticoagulants such as heparin and anti-C5a antagonists could be employed to minimize lung damage and prevent systemic involvements.
32479921 One of these patients was treated with therapeutic doses of low-molecular-weight heparin, after which no further deterioration in kidney function was observed.
32493073 In this report, we present a case of a 57-year-old woman who presented to the clinic’s infectious department with swelling, pain, warmth, and redness in the left leg who was treated with therapeutic heparin.
32504106 All inpatient CoViD-19 patients should receive thrombosis prophylaxis with low molecular weight heparin.
32510771 We reduced immunosuppressive regimen in all these patients, typically holding the antiproliferative agent and augmenting steroids; everybody received hydroxychloroquine, initial empiric antibiotic treatment with piperacillin/tazobactam, and high-dose low molecular weight heparin.
32515570 In patients with COVID-19 who are suspected of VTE or in whom the diagnosis is confirmed, parenteral therapy with low-molecular-weight heparin should be initiated in the absence of contraindications. […] If heparin-induced thrombocytopenia is suspected, nonheparin anticoagulants should be used such as bivalirudin or fondaparinux.
32516124 Following 6 weeks of therapeutic dose low-molecular-weight heparin (LMWH) treatment, the cancerous colonic section was resected.
32516429 The most commonly used in-hospital anticoagulants, unfractionated heparin (UFH) and low molecular weight heparin (LMWH), require antithrombin (AT) to exert their anticoagulant effect (Bussey and Francis 2004).
32519894 Observed hypercoagulability in COVID-19 patients has created debate within the critical care community on the therapeutic utility of heparin. […] We seek to provide an overview of the data supporting the therapeutic use of heparin, both unfractionated and low molecular weight, as an anticoagulant for the treatment of SARS-CoV-2 infection. […] Additionally, we review preclinical evidence establishing biological plausibility for heparin and synthetic heparin-like drugs as therapies for COVID-19 through anti-viral and anti-inflammatory effects. […] Finally, we discuss known adverse effects and theoretical off-target effects that may temper enthusiasm for the adoption of heparin as a therapy in COVID-19 without confirmatory prospective randomized controlled trials. […] Despite previous failures of anticoagulants in critical illness, plausibility of heparin for COVID-19 is sufficiently robust to justify urgent randomized controlled trials to determine the safety and effectiveness of this therapy.
32526092 Emerging evidence suggests that the use of heparin in these patients could be associated with lower mortality[2].
32526252 Respiratory-support was necessary in 71%, 52% received antivirals, 80% heparin.
32526763 In our opinion, the use of heparin could play a crucial role in these patients. […] In fact, recent studies have shown that heparin, the most commonly used anticoagulant during HD procedures, had anti-inflammatory properties and a direct antiviral action, due to its ability to prevent SARS-CoV-2 pseudovirus entry into host cells. […] These activities, together with its anticoagulant action, could explain the ability of heparin to ameliorate COVID-19 clinical course.
32531538 Hesperidin mixture with diosmin co-administrated with heparin protect against venous thromboembolism which may prevent disease progression.
32532939 The thrombotic phenomena described in the pulmonary vascular bed of patients with severe COVID-19 suggest the administration of low-molecular weight heparin (LMWH) as standard measure in hospitalized patients with COVID-19.
32534175 Since high mortality rates from sepsis induced DIC due to COVID-19 infection has also been associated with thrombotic events and elevated levels of D-dimer, randomized controlled trials of using anticoagulant therapy with heparin is urgently required. […] The use of acetazolamide with or without sildenafil also needs to be explored with or without heparin, since increased oxygen delivery to vital organs through prevention of thrombosis/pulmonary emboli along with carbonic anhydrase inhibition may help increase oxygenation and prevent adverse clinical outcomes.
32542212 Recent evidence reports that the use of low-molecular-weight heparin reduces mortality in patients with severe coronavirus with coagulopathy. […] Although the full scope of the benefits from heparin for COVID-19 patients is unfolding, encouraging clinical data suggest that heparin-like molecules may represent a useful approach to treat or prevent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. […] The intent of this article is to offer our opinions on the mechanism(s) by which heparin may attenuate the course of SARS-CoV-2 infection. […] Furthermore, we propose a novel strategy to treat or prevent SARS-CoV-2 infection using “designer” heparin molecules that are fabricated using a synthetic biology approach.
32550069 Due to the failure of patients to respond to the prophylactic doses of heparin recommended by ISTH, higher doses of heparin may be necessary to achieve adequate anticoagulation. […] Patients’ resistance to prophylactic doses of heparin could be due to low levels of anti-thrombin and high levels of fibrinogen, which would reinforce the use of therapeutic doses of heparin in the early stages of hospitalization. […] The review also compares low-molecular-weight heparin (LMWH) and unfractionated heparin (UFH) as anticoagulant choices for COVID-19 patients. […] New anticoagulant, nafamostat, used in Japan is also discussed as a possible potentiate for heparin therapy.
32555568 Case 3: a 77-year-old man with SARS-CoV-2 pneumonia who developed a venous thromboembolic event despite thromboprophylaxis with low molecular weight heparin.
32556875 These studies all included different interventions (thromboprophylaxis with unfractionated heparin (UFH) or low molecular-weight heparin (LMWH); an intensive thromboprophylaxis protocol with LMWH, antithrombin, and clopidogrel; and salvage therapy with tissue plasminogen activator and heparin).
32560658 The impact of obesity in severe COVID-19 has also been highlighted.In this context, standard doses of low molecular weight heparin (LMWH) may be inadequate in ICU patients, with obesity, major inflammation, and hypercoagulability. […] In all obese patients (high thrombotic risk), adjusted prophylaxis with intermediate doses of LMWH (e.g., enoxaparin 4000 IU/12 h SC or 6000 IU/12 h SC if weight > 120 kg), or unfractionated heparin (UFH) if renal insufficiency (200 IU/kg/24 h, IV), is proposed. […] In all these situations, therapeutic doses of LMWH, or UFH in case of renal insufficiency with monitoring of anti-Xa activity, are proposed.In conclusion, intensification of heparin treatment should be considered in the context of COVID-19 on the basis of clinical and biological criteria of severity, especially in severely ill ventilated patients, for whom the diagnosis of pulmonary embolism cannot be easily confirmed.
32560665 Entanglement between inflammation and coagulation and resistance to heparin provide a rationale to consider other therapeutic approaches in order to preserve endothelial function and limit microthrombosis, especially in severe forms. […] These strategies include nebulized heparin, N-acetylcysteine, plasma exchange and/or fresh frozen plasma, plasma derivatives to increase the level of endogenous anticoagulants (tissue factor pathway inhibitor, activated protein C, thrombomodulin, antithrombin), dipyridamole, complement blockers, different types of stem cells, and extracellular vesicles.
32561465 Heparin, clinically used as an anticoagulant, has also anti-inflammatory properties including binding of inflammatory cytokines, inhibition of neutrophil chemotaxis, protection of endothelial cells and a potential antiviral effect. […] We hypothesized that low molecular weight heparin (LMWH) may attenuate cytokine storm in COVID-19 patients therefore LMWH could be a valid adjunctive therapeutic drug for the treatment of COVID-19 pneumopathy. […] In this paper we review potential mechanisms involved in coagulation impairment following viral infection and the possible role of heparin in the treatment of COVID-19 patients.
32562915 In the absence of a therapy of proven efficacy, current management consists of off-label or compassionate use therapies based on antivirals, antiparasitic agents in both oral and parenteral formulation, anti-inflammatory drugs, oxygen therapy and heparin support and convalescent plasma.
32569013 Low molecular weight heparin appears to be associated with good prognosis in COVID-19 patients and has the ability to reduce coagulation and inflammation markers.
32569708 The inflammatory phase includes therapeutic options like Tocilizumab, Anakinra, Baricitinib, Eculizumab, Emapalumab and Heparin.
32570240 Retroviral therapy, antibiotics, heparin, and chloroquine were prescribed at the beginning.
32581015 Anticoagulant therapy, mainly with low molecular weight heparin (LMWH), appears to be associated with better prognosis in patients with severe COV-ID-19.
32583809 Although the International Society on Thrombosis and Haemostasis (ISTH) interim guidance recommends low molecular weight heparin in all hospitalized patients, data is lacking in population below 14 years of age. […] However, in the presence of life-threatening thromboembolic event or symptomatic acro-ischemia, unfractionated heparin (UFH) should be used with caution.
32586214 A number of antithrombotic drugs have been proposed as potential therapies to prevent COVID-19-associated thrombosis, including, heparin, FXII inhibitors, fibrinolytic drugs, nafamostat and dipyridamole, many of which also possess pleiotropic anti-inflammatory or anti-viral effects.
32586394 To assess whether high doses of Low Molecular Weight Heparin (LMWH) (i.e. […] History of heparin induced thrombocytopenia 8. […] Administration of therapeutic doses of LMWH, fondaparinux, or unfractionated heparin (UFH) for more than 72 hours before randomization; prophylactic doses are allowed 12. […] Assuming an alpha of 5% (two tailed) and a percentage of patients who experience clinical worsening in the control group being between 25% and 30%, the study will have 80% power to detect at least 50% relative reduction in the risk of death between low and high doses of heparin.
32589931 Heparin resistance is an uncommon phenomenon defined as the need for high dose unfractionated heparin (UFH) of more than 35,000 IU/day to achieve the target activated partial thromboplastin time ratio or the failure to achieve the desired activated clotting time after a full UFH dose. […] We describe a Covid-19 patient confirmed by reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay, with acute limb ischemia, who developed heparin resistance.