Low molecular weight heparin in COVID-19 patients prevents delirium and shortens hospitalization

Neurol Sci. 2021 Apr;42(4):1527-1530. doi: 10.1007/s10072-020-04887-4. Epub 2020 Nov 13.

Abstract

Background: COVID-19 patients present with delirium during their hospitalization.

Aims: To assess the incidence of delirium in hospitalized COVID-19 patients and analyze the possible association with demographic, clinical, laboratory, and pharmacological factors.

Methods: COVID-19 patients were assessed for clinical signs of delirium and administered the assessment test for delirium and cognitive impairment (4AT) and the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) scales.

Results: Out of the 56 patients of our cohort, 14 (25.0%) experienced delirium. The use of low molecular weight heparin (LMWH) (enoxaparin 1 mg/kg/daily) was less frequent in patients with delirium (p = 0.004) and was accompanied by lower C reactive protein (CRP) levels (p = 0.006).

Discussion: The use of LMWH was associated with absence of delirium, independently of comorbidities and age.

Conclusions: The use of LMWH may help preventing the occurrence of delirium in COVID-19 patients, with possible reduction of length of stay in the hospital and sequelae.

Keywords: C reactive protein; COVID-19; Delirium; Low molecular weight heparin.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anticoagulants / therapeutic use*
  • C-Reactive Protein / analysis
  • COVID-19 / complications*
  • COVID-19 / psychology
  • Cognition Disorders / etiology
  • Cognition Disorders / psychology
  • Cohort Studies
  • Comorbidity
  • Confusion / psychology
  • Delirium / etiology*
  • Delirium / prevention & control*
  • Delirium / psychology
  • Enoxaparin / therapeutic use*
  • Female
  • Heparin, Low-Molecular-Weight / therapeutic use*
  • Humans
  • Inpatients
  • Length of Stay
  • Male
  • Neuropsychological Tests

Substances

  • Anticoagulants
  • Enoxaparin
  • Heparin, Low-Molecular-Weight
  • C-Reactive Protein