Anticoagulation Strategies in Non-Critically Ill Patients Hospitalized with COVID-19: A Randomized Clinical Trial

• Published in: Journal of the American College of Cardiology 2023-03
• Main Authors: Stone, Gregg W., Farkouh, Michael E., Lala, Anuradha, Tinuoye, Elizabeth, Dressler, Ovidiu, Moreno, Pedro R., Palacios, Igor F., Goodman, Shaun G., Esper, Rodrigo B., Abizaid, Alexandre, Varade, Deepak, Betancur, Juan F., Ricalde, Alejandro, Payro, Gerardo, Castellano, José María, Hung, Ivan FN, Nadkarni, Girish N., Giustino, Gennaro, Godoy, Lucas C., Feinman, Jason, Camaj, Anton, Bienstock, Solomon W., Furtado, Remo H.M., Granada, Carlos, Bustamante, Jessica, Peyra, Carlos, Contreras, Johanna, Owen, Ruth, Bhatt, Deepak L., Pocock, Stuart J., Fuster, Valentin
• Format: Article
• Language: English
• Subjects: Original Investigation
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/j.jacc.2023.02.041

Condensed abstract: We randomized 3398 patients hospitalized with COVID-19 not yet requiring intensive care unit (ICU) management to prophylactic-dose enoxaparin, therapeutic-dose enoxaparin or therapeutic-dose apixaban at 76 centers in 10 countries. The 30-day primary composite outcome of all-cause mortality, requirement for ICU level-of-care, systemic thromboembolism, or ischemic stroke was not significantly reduced in the combined therapeutic-dose anticoagulation groups compared with prophylactic-dose anticoagulation. However, fewer patients who were treated with therapeutic-dose anticoagulation required intubation or died. The benefits of therapeutic-dose anticoagulation were most strongly evident in higher-risk patients.