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      LOW-MOLECULAR-WEIGHT-HEPARIN AS PROPHYLAXIS FOR ORTHOPEDIC COVID-19 PATIENTS: OFF-LABEL FOR DOSAGE OR INDICATION FOR INCREASED RISK?

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            Abstract

            In COVID-19, thromboembolic complications represent one of the most relevant signs associated with mortality. It has been proposed the use of LMWH in therapeutic dosage therefore off-label. Between March and April 2020, sixteen patients with COVID-19 were admitted to our structure for major non-deferrable orthopedic surgery. The first series of patients received prophylactic treatment of 4000 UI/die of LMWH, while the second series of 9 patients were treated with 4000 IU/twice a day. The data collected and published so far indicate that LMWH has a favorable benefit/risk ratio with efficacy in the prophylaxis of thromboembolic phenomena in COVID-19 patients undergoing orthopedic surgery, greater than any adverse events. The reduction of associated disseminated thromboembolic phenomena with the escalated dose of LMWH does not represent the cure for COVID-19 but could favor survival. It will be necessary to collect further data on the off-label use of LMWH in this patient setting to legitimize a request for extension of indication to the regulatory authorities.

            Content

            Author and article information

            Journal
            ScienceOpen Posters
            ScienceOpen
            27 November 2020
            Affiliations
            [1 ] IRCCS Orthopedic Institute Galeazzi
            Author information
            https://orcid.org/0000-0003-0801-2359
            Article
            10.14293/S2199-1006.1.SOR-.PPBF81V.v1
            a46bc3ac-d6dc-4394-b6cf-c5ff0e0ca438

            This work has been published open access under Creative Commons Attribution License CC BY 4.0 , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Conditions, terms of use and publishing policy can be found at www.scienceopen.com .

            History
            : 27 November 2020

            Data sharing not applicable to this article as no datasets were generated or analysed during the current study.
            Cardiovascular Medicine,Anesthesiology & Pain management,Pharmacology & Pharmaceutical medicine,Infectious disease & Microbiology
            COVID-19,Venous Thromboembolism,Heparin,Blood coagulation

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