Low Molecular Weight Heparin Doses and Ventilator Airway Necessity in the COVID-19 Patients: Systematic Review and Meta-analysis

BACKGROUND: Anticoagulant therapy is recommendation for COVID-19 infection. However, the mechanical ventilation needed for COVID-19 is still high.AIM: The aim of the study was to determine comparison therapeutic and prophylactic dose LMWH for mechanical necessity in COVID-19 infection.METHODS: A systematic literature search articles online from studies published between 2020 and 2021 that met our inclusion criteria and were retrieved from scientific databases such as Cochrane, ProQuest, and PubMed. The primary measure was a composite bad outcome, which included mechanical ventilation, mortality. and bleeding risk.RESULTS: There were 3432 patients from seven study included in this meta-analysis for necessity of mechanical ventilation in COVID-19 patients that used prophylactic and therapeutic anticoagulants. Prophylactic dose of anticoagulant showed no difference for the need for mechanical ventilation necessity for COVID-19 patients (RR = 0.54; 95% CI = 0.20–1.48; p = 0.23). However, prophylactic anticoagulant showed more safe for bleeding incidence (RR = 0.27; 95% CI = 0.18–0.39; p = <0.00001) and reduce mortality (RR = 0.52; 95% CI = 0.46-0.58; p = <0.00001).CONCLUSION: LMWH anticoagulant dose not associated with reduce mechanical ventilation necessity but prophylactic dose prefers rather than therapeutic dose for reduce mortality and risk of bleeding.