PMC:7381711 / 1548-2951
Annnotations
{"target":"https://pubannotation.org/docs/sourcedb/PMC/sourceid/7381711","sourcedb":"PMC","sourceid":"7381711","source_url":"https://www.ncbi.nlm.nih.gov/pmc/7381711","text":"INTRODUCTION\nCoronavirus 2019 (COVID-19), the disease associated with infection by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first reported in December 2019 (50) and is now the most significant worldwide public health crisis since the influenza pandemic of 1918. Despite this immense global burden, no pharmacologic therapies have proven definitively beneficial (25). On the basis of our clinical experience in intensive care units in Colorado and those shared by the wider critical care community, we conclude that many therapies are being administered despite limited evidence. Anticoagulants that have been utilized widely are unfractionated (full-length) heparin and low-molecular weight heparins. For the purposes of this review, heparin herein refers to both unfractionated and low-molecular weight variants, unless otherwise designated.\nIn this review, we discuss the pathophysiologic rationale and current evidence for the use of full-dose heparin (i.e., therapeutic rather than prophylactic dosing) as an anticoagulant in COVID-19. We also discuss a subset of non-anticoagulant effects of heparin that may prove beneficial for the treatment of COVID-19. Finally, we discuss potential risks associated with the implementation of heparin for the treatment of SARS-CoV-2, including but not limited to bleeding and immune-mediated heparin-induced thrombocytopenia 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