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Heparin and Coronavirus

6 Apr 2020
The b blog

By Javier Velasco, Bioiberica R&D Director

The COVID-19 pandemic is proving to be a tragedy in terms of its effects on human health and will have highly concerning consequences for global economies. In this context, many research teams have in record time focused on finding solutions for the treatment and prevention of this disease.

Heparin, the active pharmaceutical ingredient that Bioiberica has been producing since 1975, is considered by the World Health Organization (WHO) as an essential medicine and in fact both unfractioned heparin (UFH) and its low molecular weight derivatives (LMWH) constitute the most commonly used anticoagulants for the prevention and treatment of thrombosis worldwide.

In the context of the health crisis caused by COVID-19, the WHO has published Clinical Management Guidelines  for patients critically ill from coronavirus infection. It has been described that in some patients with COVID-19, especially those hospitalised and in advanced stages of the disease, venous thromboembolic (VTE) occurs, a disorder that includes deep vein thrombosis (DVT), and pulmonary embolisms (PE). VTE refers to an abnormal blood clot that forms in a deep vein, usually in the lower leg, thigh, or pelvis. A PE occurs when a clot breaks loose and travels through the bloodstream to the lungs.  Prophylaxis and treatment of VTE, caused by any reason, is one of heparin’s main uses. It is not surprising, therefore, that in these guides and several research papers  recommend the use of UFH or LMWH to alleviate the risks of coagulopathies in these critical patients derived from COVID-19.

It should be noted that these uses of heparin reinforce its role as a complementary agent for the treatment of several secondary complications of COVID-19 but not as a primary nor, of course, preventive treatment.

However, in addition to its capacity as an anticoagulant, the heparin molecule's potential for the development of new drugs due to its anti-tumour, anti-inflammatory, and antiviral activity has been described for many years.

In particular, the ability of heparin and other glycosaminoglycans (GAGs) to bind to the coronavirus has already been described. This binding capacity could lead to an antiviral activity of heparin derived from the "capture” of the viruses due to its strongly negative structure and charge.

A very recent article describes the ability of heparin to bind in vitro to a specific protein (RBD) in COVID-19. Due to this activity, exploring heparin (or derivatives of it or other GAGs lacking anticoagulant activity) as a possible therapeutic agent against coronavirus has been proposed. Although this application is still far from clinical application - as it would require the corresponding clinical studies - we consider monitoring scientific progress in this regard of significant interest.

In the face of this health and social crisis, our responsibility and commitment is to continue working to guarantee the production and distribution of heparin and all our active pharmaceutical ingredients, with the highest quality and safety standards, ensuring, to the best of our ability, regular supply to our partners and customers.