Dosing of thromboprophylaxis and mortality in critically ill COVID-19 patients

• Published in: Critical care (London, England) England), 2020-11, Vol.24 (1), p.653, Article 653
• Main Authors: Jonmarker, Sandra, Hollenberg, Jacob, Dahlberg, Martin, Stackelberg, Otto, Litorell, Jacob, Everhov, Åsa H, Järnbert-Pettersson, Hans, Söderberg, Mårten, Grip, Jonathan, Schandl, Anna, Günther, Mattias, Cronhjort, Maria
• Format: Article
• Language: English
• Subjects: Aged; Anticoagulants; Anticoagulants - administration & dosage; APACHE; Blood; Body mass index; Coronaviruses; COVID-19; COVID-19 - mortality; Critical care; Critical Illness - mortality; Critically ill; Dalteparin - administration & dosage; Drug dosages; Drug therapy; Embolisms; Female; Humans; Intensive care; Intensive Care Units; Laboratories; Male; Medical records; Medicin och hälsovetenskap; Middle Aged; Mortality; Patients; Respiratory failure; Retrospective Studies; Risk factors; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Sweden - epidemiology; Thromboembolism; Thrombosis - mortality; Thrombosis - prevention & control; Tinzaparin - administration & dosage; Tomography
• ISSN: 1364-8535; 1466-609X; 1466-609X; 1364-8535; 1366-609X
• DOI: 10.1186/s13054-020-03375-7

A substantial proportion of critically ill COVID-19 patients develop thromboembolic complications, but it is unclear whether higher doses of thromboprophylaxis are associated with lower mortality rates. The purpose of the study was to evaluate the association between initial dosing strategy of thromboprophylaxis in critically ill COVID-19 patients and the risk of death, thromboembolism, and bleeding. In this retrospective study, all critically ill COVID-19 patients admitted to two intensive care units in March and April 2020 were eligible. Patients were categorized into three groups according to initial daily dose of thromboprophylaxis: low (2500-4500 IU tinzaparin or 2500-5000 IU dalteparin), medium (> 4500 IU but  5000 IU but