A meta-trial of randomized clinical studies suggested that inhaled heparin “dramatically reduced the risk of intubation, death, and in-hospital death in hospitalized COVID-19 patients.” CIDRAP has the news.
Researchers analyzed “pooled data from trials involving 478 adult COVID-19 patients who were hospitalized but didn't require mechanical ventilation.” The patients had been “randomly assigned to receive either inhaled nebulized unfractionated heparin (UFH) in addition to standard care or standard care alone to prevent intubation or death or in-hospital death from June 2020 to December 2022. In total, 238 patients were in the UFH group, and 240 were controls.”
UFH is “typically injected” and has “antiviral, anti-inflammatory, and anti-coagulant properties, which may prevent viral entry, lung injury progression, and pulmonary thrombosis.”
In-hospital death “among nebulized-UFH recipients was 4.3%, compared with 14.3% in controls.” The lack of heterogeneity in treatment effect between studies suggests that “the overall effect was consistent between studies, and no difference was observed in treatment effect between patients given supplementary oxygen at baseline and those who weren't.” A consistent reduction in intubation or death was seen “at the longest follow up in the UFH group compared with controls,” and UFH recipients “had a shorter median hospital length of stay than the control group (6 vs 7 days) when death before hospital release was treated as a competing event.”
