Anticoagulant and antiarrhythmic effects of heparin in the treatment of COVID‐19 patients

Menezes‐Rodrigues, Francisco Sandro; Padrão Tavares, José Gustavo; Pires de Oliveira, Marcelo; Guzella de Carvalho, Rafael; Ruggero Errante, Paolo; Omar Taha, Murched; Fagundes, Djalma José; Caricati‐Neto, Afonso

Most severe manifestations of COVID‐19 cases, such as multiple organ failure and death, have been linked to coagulation dysfunction markers, such as platelet reduction and increases in prothrombin time, fibrin degradation products and, mainly, D‐dimer [1]. A recent paper by Tang et al. [2] in this journal reported that heparin treatment reduced mortality of COVID‐19 patients with elevated D‐dimer; similar preliminary results have been reported elsewhere [3]. A mounting body of evidence shows that SARS‐CoV‐2 causes a “cytokine storm” [1,4] that activates the coagulation cascade, leading to thrombosis. Similar to the findings in severe sepsis, generalized deposition of intravascular thrombi compromises the blood supply of several organs, leading to organ failure [5].