Study population
Patients with a positive SARS-CoV 2 RT PCR test who required hospitalisation were included in the trial. Patients were required to have a WHO modified ordinal clinical scale (MOCS) score (Table 1) of 3 – 5; subjects requiring mechanical ventilation were not eligible. Exclusion criteria included known hypersensitivity to heparin or related compounds, or the diagnosis of a pulmonary obstructive disease. Any patients requiring admission to ICU ceased to receive any further treatment with nebulised UFH.
We collected the following baseline demographic and clinical data: age, sex, co-morbidities, WHO modified ordinal clinical scale (MOCS) for COVID-19, as shown in Table 1, level of respiratory support, other treatments reflecting the standard of care in use during the time of the trial, including the use of any prophylactic or therapeutic anti-coagulant treatment. We also collected the following treatment-related variables: nebulised UFH dose (daily and cumulative), treatment duration, missed doses and reasons for this. The following safety outcomes were also assessed: baseline and peak activated partial thromboplastin time (APTT), the incidence of epistaxis, blood-stained sputum, pulmonary bleeding, major bleeding, heparin-induced thrombocytopenia, and any other serious adverse events.
Table 1. WHO modified ordinal clinical scale (MOCS) for COVID-19