Biomarkers of Apoptosis and Systemic Inflammation in Patients with COVID-19 Undergoing Targeted Anticoagulant Therapy

Background: We assessed apoptosis biomarkers alongside systemic inflammatory indices in patients diagnosed with COVID-19 undergoing targeted anticoagulant therapy. Methods: A prospective cohort study involved a total of 370 patients hospitalized with COVID-19 from 2021 to 2022. One hundred ninety patients with COVID-19 received low-molecular-weight heparins, LMWH (group 1), one hundred twenty-three patients received unfractionated heparin, UFH (group 2), and fifty-seven patients received direct oral anticoagulants, DOAC (group 3). The diagnostic protocol included assessment of clinical and anamnesis data, evaluation of biomarkers of apoptosis (phosphatidylserine and calreticulin) and systemic inflammation (C-reactive protein, ferritin, procalcitonin) alongside duplex venous ultrasonography of the lower extremities executed to screen for venous thromboembolic complications. Results: The LMWH regimen elicited a substantial chronological surge in phosphatidylserine concentrations, demonstrating an 18.4% increment from baseline parameters (p = 0.012) in COVID-19 patients. Baseline phosphatidylserine levels above 62.75 pg/mL were a protective factor associated with attenuating the odds of developing an episode of venous thromboembolism by 1.033 (p = 0.02). Conclusions: Phosphatidylserine can be used as a prognostic measure to evaluate the odds of developing a VTE episode. LMWHs exert more potent pleiotropic anti-inflammatory and systemic anticoagulant activities within this infectious framework compared to alternative ACT protocols.