Mochamad Yusuf Alsagaff, - and Eka Prasetya Budi Mulia, - and Irma Maghfirah, - and Yusuf Azmi, - and Dita Aulia Rachmi, - and Alqi Yutha, - and Luqman Hakim Andira, - and Bambang Pujo Semedi, - (2022) Low molecular weight heparin is associated with better outcomes than unfractionated heparin for thromboprophylaxis in hospitalized COVID-19 patients: a meta-analysis. European Heart Journal - Quality of Care and Clinical Outcomes, 8 (8). pp. 909-918. ISSN 2058-5225

	Text (Artikel) 17. Low molecular weight heparin is associated with better outcomes than unfractionated heparin for thromboprophylaxis in hospitalized COVID-19 patients a Meta Analys.pdf Download (826kB)
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Abstract

Aims This study aimed to compare the outcomes of the administration of LMWH and UFH in hospitalized COVID-19 patients. Methods and results We systematically searched several databases and included observational studies or clinical trials that compared the outcomes of the administration of LMWH and UFH in hospitalized COVID-19 patients. A total of nine studies comprising 9637 patients were included. Metanalysis showed that LMWH administration was associated with a lower in-hospital mortality and 28/30-day mortality compared with UFH administration {[relative risk (RR) 0.44; 95% confidence interval (95% CI) 0.32–0.61; I2: 87.9%] and (RR 0.45; 95% CI 0.24–0.86; I2: 78.4%), respectively}. Patient with LMWH had shorter duration of hospital and ICU length of stay compared with UFH {[weighted mean difference (WMD) −2.20; 95% CI −3.01 to −1.40; I2:0%] and (WMD −1.41; 95% CI −2.20 to −0.63; I2: 0%), respectively}. The risk of ICU admission or mechanical ventilation was lower in patients who received LMWH than in those who received UFH (RR 0.67; 95% CI 0.55–0.81; I2: 67.3%). However, there was no difference in the incidence of bleeding with LMWH compared with UFH (RR 0.27; 95% CI 0.07–1.01; I2: 64.6%). Conclusion Our meta-analysis showed that administration of LMWH was associated with better outcomes compared with UFH in hospitalized COVID-19 patients. Prospective cohorts and RCTs are urgently needed to explore the definitive effect of LMWH to provide direct high-certainty evidence.

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