For patients hospitalized with COVID-19 who are not critically ill, therapeutic-dose anticoagulation is beneficial<\/p>\n<\/h3>\n
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MONDAY, Aug. 16, 2021 (HealthDay News) — Therapeutic-dose anticoagulation with heparin does not improve outcomes for critically ill patients with severe COVID-19, but it is beneficial for patients who are not critically ill, according to two studies published online Aug. 4 in the New England Journal of Medicine<\/em>.<\/p>\n Ewan C. Goligher, M.D., Ph.D., from the University of Toronto, and colleagues randomly assigned critically ill patients with severe COVID-19 to either therapeutic-dose anticoagulation with heparin or pharmacologic thromboprophylaxis concordant with usual care. When the prespecified criterion for futility was met for therapeutic-dose anticoagulation, the trial was stopped. Data on the primary outcome were available for 534 patients assigned to therapeutic-dose anticoagulation and 564 assigned to usual-care thromboprophylaxis. The researchers found that the median value for organ support-free days was one and four among patients assigned to therapeutic-dose anticoagulation and usual-care thromboprophylaxis, respectively (adjusted proportional odds ratio, 0.83; 95 percent credible interval, 0.67 to 1.03; posterior probability of futility, 99.9 percent).<\/p>\n Patrick R. Lawler, M.D., M.P.H., from the Peter Munk Cardiac Centre at the University Health Network in Toronto, and colleagues randomly assigned patients hospitalized with COVID-19 who were not critically ill to either therapeutic-dose anticoagulation or usual-care pharmacologic thromboprophylaxis. When the prespecified criteria for the superiority of therapeutic-dose anticoagulation were met, the trial was stopped. The researchers found that among 2,219 patients in the final analysis, there was a 98.6 percent probability that therapeutic-dose anticoagulation increased organ support-free days compared with usual-care thromboprophylaxis (adjusted odds ratio, 1.27).<\/p>\n “Initiating therapeutic anticoagulation is beneficial for moderately ill patients and once patients develop severe COVID-19, it may be too late for anticoagulation with heparin to alter the consequences of this disease,” a coauthor from the Lawler study said in a statement.<\/p>\n Several authors from both studies and the editorial disclosed financial ties to the biopharmaceutical industry.<\/p>\n Abstract\/Full Text – Goligher<\/a><\/p>\n Abstract\/Full Text – Lawler<\/a><\/p>\n