Early low-molecular-weight heparin administration is associated with shorter time to SARS-CoV-2 swab negativity.

IF 2.3 4区医学 Q4 INFECTIOUS DISEASES

Antiviral Therapy Pub Date : 2020-01-01 DOI:10.3851/IMP3377

Mattia Trunfio, Elena Salvador, Alberto Gaviraghi, Sabrina Audagnotto, Letizia Marinaro, Ilaria Motta, Riccardo Casciaro, Valeria Ghisetti, Carmen Fava, Stefano Bonora, Giovanni Di Perri, Andrea Calcagno

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引用次数: 5

Abstract

Background: Antiviral and immune-modulating properties of low-molecular-weight heparin (LMWH) against Coronaviridae have been reported by in vitro studies, but no in vivo evidence is yet available. We sought to know whether the timing of prophylactic doses of LMWH during the course of COVID-19 may affect the time to SARS-CoV-2 nasal-oropharyngeal swab negativization.

Methods: Retrospective monocentric cross-sectional study on patients requiring sub-intensive ward admission due to first SARS-CoV-2 infection and undergoing early (EH; within 7 days from COVID-19 signs and symptoms onset) versus delayed prophylactic LMWH (DH; after 7 days). SARS-CoV-2 RNA was measured by reverse transcription real-time PCR according to scheduled time points: first swab after 2 weeks from COVID-19 onset, then at 1-week intervals until negativity.

Results: Time to SARS-CoV-2 swab negativity was shorter in EH (38 patients) compared with DH (55 patients): 22 versus 37 days (P=0.004). The number of confirmative negative swabs in EH was significantly higher compared with DH at week 2 (21.1% versus 3.6%; P=0.017) and 4 (60.0% versus 19.6%; P<0.001). At univariate, EH differed from DH for several disease severity and clinical management parameters. Nevertheless, after accounting for the differences, Cox regression showed early LMWH administration (hazard ratio [HR] 2.91 [1.51, 5.63]; P=0.002) and higher lymphocytes nadir (HR 1.04 [1.01, 1.08]; P=0.020) as predictors of shorter time to swab negativity.

Conclusions: This potential antiviral and/or immune-modulating activity of LMWH needs further in vivo confirmations by randomized controlled trials.

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早期给予低分子肝素与较短的SARS-CoV-2拭子阴性时间相关。

背景:低分子肝素(LMWH)对冠状病毒的抗病毒和免疫调节特性已被体外研究报道，但尚未有体内证据。我们试图了解在COVID-19过程中预防剂量低分子肝素的时间是否会影响到SARS-CoV-2鼻口咽拭子阴性的时间。方法:回顾性单中心横断面研究首次感染SARS-CoV-2并接受早期(EH;COVID-19体征和症状出现后7天内)与延迟预防性低分子肝素(DH;7天后)。根据计划的时间点，采用逆转录实时PCR检测SARS-CoV-2 RNA:在COVID-19发病2周后第一次拭子，然后每隔1周拭子一次，直到阴性。结果:EH组(38例)到SARS-CoV-2拭子阴性的时间比DH组(55例)短:22天比37天(P=0.004)。第2周EH确诊阴性拭子数明显高于DH (21.1% vs 3.6%;P=0.017)和4 (60.0% vs 19.6%;结论:低分子肝素潜在的抗病毒和/或免疫调节活性需要进一步的体内随机对照试验证实。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Antiviral Therapy 医学-病毒学

CiteScore

2.60

自引率

8.30%

发文量

审稿时长

4-8 weeks

期刊介绍： Antiviral Therapy (an official publication of the International Society of Antiviral Research) is an international, peer-reviewed journal devoted to publishing articles on the clinical development and use of antiviral agents and vaccines, and the treatment of all viral diseases. Antiviral Therapy is one of the leading journals in virology and infectious diseases. The journal is comprehensive, and publishes articles concerning all clinical aspects of antiviral therapy. It features editorials, original research papers, specially commissioned review articles, letters and book reviews. The journal is aimed at physicians and specialists interested in clinical and basic research.