Heparin Resistance in a COVID-19 patient: A Rare Occurrence
Coronavirus disease-2019 (COVID-19) in severe cases is associated with marked inflammation in mainly the lungs. Reports suggest a beneficial role of heparin/low molecular weight heparin (LMWH) in reducing mortality and morbidity in such patients. We have summarized potential beneficial, anti-inflammatory mechanisms underlying treatment of COVID-19 patients with heparin/LMWH. Herein, we present a rare case of severe COVID-19 showing Heparin Resistance (HR), which was primarily suspected due to constantly elevated inflammatory markers like CRP, D-dimer, IL-6 and subtherapeutic levels of aPTT when the patient was on Heparin. These parameters showed remarkable changes when Heparin was replaced by LMWH, Dalteparin and eventually the condition of patient ameliorated.
2. Gray, E.; Mulloy, B.; Barrowcliffe, T.W. Heparin and Low-Molecular-Weight Heparin. Thromb. Haemost. 2008, 99, 807–818
3. Baranca Buijsersa, Cansu Yanginlara, Marissa L. Maciej-Hulmea, Quirijn de Mastb , Johan van der Vlaga: Beneficial non-anticoagulant mechanisms underlying heparin treatment of COVID-19 patients. https://doi.org/10.1016/j.ebiom.2020.102969
4. Durrani, J., Malik, F., Ali, N., & Jafri, S. I. M. (2018). To be or not to be a case of heparin resistance. Journal of Community Hospital Internal Medicine Perspectives, 8(3), 145–148. doi:10.1080/20009666.2018.1466599
5. McGlynn, F., McGrath, J., Varghese, C., Ryan, B., McHugh, J., Fahy, A., & Enright, H. (2020). Argatroban for therapeutic anticoagulation for heparin resistance associated with Covid-19 infection. Journal of Thrombosis and Thrombolysis. doi:10.1007/s11239-020-02251-z
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