Therapeutic Low-Dose Heparin Significantly Reduces Major Clotting and Death in High-Risk Hospitalized COVID-19 Patients

The HEP-COVID clinical trial conducted by researchers at the Feinstein Institutes for Medical Research (Manhasset, NY, USA) has revealed that prophylaxis with therapeutic low-dose heparin significantly reduces major thromboembolism (clotting) and death in high-risk hospitalized COVID-19 patients versus standard-of-care thromboprophylaxis. Throughout the pandemic, the medical community witnessed an increased risk for major blood clotting and death in patients with coronavirus disease 2019 (COVID-19). Since May 2020, the research team enrolled 257 critically sick hospitalized adults in a randomized controlled multi-center clinical trial, HEP-COVID, to determine which dosage of heparin – an anticoagulation medication – is most effective.

The clinical trial results have shown a significant improvement at preventing these clots. The results found that the incidence of major thromboembolism and death in patients was 28.7% for those given a therapeutic-dose low-molecular-weight heparin (LMWH) versus 41.9% for those who received institutional standard prophylactic or intermediate-dose heparins. The therapeutic dose of heparin was four times that of the standard dose and patients were assessed for their risk using a relatively new elevated blood biomarker test, the D-dimer. Treatment results were not seen in patients who were critically ill requiring ICU level of care – indicating that by assessing patient risk prior to intensive care and delivering LMWH clinicians could alter the course of disease. This shift in medication dosage may result in health systems revising the current standard of care procedures for preventing thrombotic complications in high-risk COVID-19 hospitalized patients.

“In the HEP-COVID clinical trial we were able to predict a population of hospitalized COVID-19 patients that are at high risk of developing thromboembolic complications and death and alter their outcomes with a therapeutic dose of heparin, without major bleeding,” said Dr. Alex C. Spyropoulos, MD, the trial’s principal investigator and professor at Feinstein Institutes’ Institute of Health System Science. “We hope that our findings will inform other clinicians on the frontlines on the most effective weapon we have to prevent these often morbid and fatal thrombotic complications from COVID-19.”

Related Links:
The Feinstein Institutes for Medical Research