CORRELATION OF PROPHYLACTIC AND THERAPEUTIC DOSE OF LMW HEPARIN WITH RESPECT TO OUTCOME IN CRITICALLY ILL PATIENTS OF COVID-19.

Introduction- Recently, a novel coronavirus (2019-nCoV), ofcially known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), caused a severe pandemic infection worldwide with considerable morbidity and mortality. A relatively high mortality of severe coronavirus disease 2019 (COVID-19) is worrying, and the application of heparin in COVID-19 has been recommended by some expert consensus because of the risk of disseminated intravascular coagulation and venous thromboembolism. However, its efcacy remains to be validated.We aim to Correlate the association between prophylactic and therapeutic dosages of low molecular weight heparin (LMWH) on mortality and other morbidity outcomes in critically ill patients of COVID-19 . Consecutive Methodspatients admitted to Dr. S. C.GMC Medical college and hospital Nanded with laboratory-conrmed COVID-19 were included in this retrospective observational study. The diagnosis of COVID-19 was established according to World Health Organization interim guidance and conrmed by RNA detection of the SARS-CoV-2 in the microbiology laboratory of the hospital. Outcomes between COVID-19 patients treated with standard prophylactic LMWH enoxaparin dosage (subcutaneous enoxaparin 40–60 mg daily) or Therapeutic LMWH enoxaparin dosage (subcutaneous enoxaparin 40–60 mg twice daily) for 7 days were correlated. Out of 100 patients 50 re Results - ccived P-LMWH & 50 reccived T-LMWH among that 12 % patients expired in prophylactic group & 22% in therapeutic group. It was observed that the levels of D-dimer before & after of P-LMWH group were (D-dimer: 2.63±1.77, 0.63±1.19) and those of T-LMWH group were(D-dimer: 3.14 ± 2.15, 1.07 ±1.56 ). the length of hospital stay was (11 ± 2.21) days in the P-LMWH group and (11 ± 3.99 ) Days in the T-LMWH group. Simillarly the saturation level of oxygen ware (SPO2 98% ) in P-LMWH group & (SPO2 97%) in T-LMWH group. 26% patients shows adverse effects to P-LMWH group & 32% patients to T-LMWH group. Study demonstrates that if you start earlier prophylactic LMW Conclusion- heparin to critically ill patients of covid 19 with raised D-dimer level the level of d-dimer will not further increased and comes down to normal value. Simillarly patients recover earlier and reduces hospital stay of patients with improvement in oxygen saturation.