Influence of anticoagulant therapy on immune and inflammatory response in patients with community-acquired pneumonia associated with coronavirus infection

The publication raises the issue of finding ways to reduce the level of thrombotic complications in patients with community-acquired pneumonia associated with COVID-19. Aim. To determine the effect of anticoagulant therapy on the immune and inflammatory response in patients with community-acquired pneumonia associated with coronavirus infection. Material and methods. An open, prospective, observational study was conducted in the period from January 2021 to February 2022 at the Kherson City Clinical Hospital named after Athanasius and Olga Tropin of the Kherson City Council, 143 patients with community-acquired pneumonia aged 46 to 65 years who tested positive for SARS-CoV-2 were observed. To participate in the study, patients signed a voluntary consent form. Results. Patients with community-acquired pneumonia develop an immune-inflammatory response characterized by increased levels of interleukin-6 and C-reactive protein, with significantly higher values of these biomarkers in combination with COVID-19. Combination therapy is effective in reducing the levels of markers of the immune-inflammatory response Heparin at a dose of 1000 IU/h is more effective in reducing the risk of death in patients with community-acquired pneumonia associated with coronavirus infection than 100 IU anti-Xa/kg (1 mg/kg) twice daily. Conclusions. The results of our study showed that therapy with heparin is more effective than enoxaparin in reducing interleukin-6 levels within 72 hours (by -12.93 % vs -4.75 %, respectively, p < 0.05). Multivariate regression analysis determined that changes in the levels of D-dimer, interleukin-6 and INR were independent predictors of adverse disease outcome.