Coronavirus Disease 2019 (COVID-19), the clinical syndrome associated with infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has impacted nearly every country in the world. Despite an unprecedented focus of scientific investigation, there is a paucity of evidence-based pharmacotherapies against this disease. Due to this lack of data-driven treatment strategies, broad variations in practice patterns have emerged. Observed hypercoagulability in COVID-19 patients has created debate within the critical care community on the therapeutic utility of heparin. We seek to provide an overview of the data supporting the therapeutic use of heparin, both unfractionated and low molecular weight, as an anticoagulant for the treatment of SARS-CoV-2 infection. Additionally, we review preclinical evidence establishing biological plausibility for heparin and synthetic heparin-like drugs as therapies for COVID-19 through anti-viral and anti-inflammatory effects. Finally, we discuss known adverse effects and theoretical off-target effects that may temper enthusiasm for the adoption of heparin as a therapy in COVID-19 without confirmatory prospective randomized controlled trials. Despite previous failures of anticoagulants in critical illness, plausibility of heparin for COVID-19 is sufficiently robust to justify urgent randomized controlled trials to determine the safety and effectiveness of this therapy.
Heparin has also been used successfully for Lyme/MSIDS in many patients. While not curative, it does help many symptoms for those who suddenly find they have hyper coagulation. My husband used it and it made a huge difference. He has since successfully switched to
- fish oil (makes the blood slippery)
- systemic enzymes (cleans up debris in the blood including blood clots, is an anti-inflammatory, a detoxifier, minimizes allergies and more) https://madisonarealymesupportgroup.com/2018/03/05/how-proteolytic-enzymes-may-help-lyme-msids/
- berberine (helps with cholesterol and has shown activity against Bartonella among other pathogens): https://madisonarealymesupportgroup.com/2019/05/05/good-news-for-bartonella-patients-identification-of-fda-approved-drugs-with-higher-activity-than-current-front-line-drugs/)
Interestingly, heparin used prophylactically has prevented Lyme in vitro: https://madisonarealymesupportgroup.com/2020/02/05/non-anticoagulant-heparin-as-a-pre-exposure-prophylaxis-prevents-lyme-disease-infection/
The drug heparin is structurally similar to these GAGs and inhibits Bbsl attachment to PGs, GAGs, cells, and tissues, suggesting its potential to prevent LD. However, the anticoagulant activity of heparin often results in hemorrhage, hampering the development of this compound as LD PrEP.