March 19, 2021

Effect of Intermediate-Dose vs Standard-Dose Prophylactic Anticoagulation on Thrombotic Events, Extracorporeal Membrane Oxygenation Treatment, or Mortality Among Patients With COVID-19 Admitted to the Intensive Care Unit

Category: Article Summary

Topic: Testing and Treatment

Keywords (Tags): treatment

• Intermediate-dose prophylactic anticoagulation treatment did not improve clinical outcomes among patients admitted to the ICU with COVID-19 compared with standard prophylactic anticoagulation, according to a randomized clinical trial (n=562). There was no difference in the primary composite outcome (an adjudicated venous or arterial thrombosis, treatment with extracorporeal membrane oxygenation, or mortality within 30 days) between patients treated with standard doses of enoxaparin typically used to prevent venous thromboembolism (equivalent to 40mg of enoxaparin daily) versus intermediate doses (1 mg/kg enoxaparin equivalent daily). The authors conclude that these results do not support the routine empirical use of intermediate-dose prophylactic anticoagulation in unselected patients admitted to the ICU with COVID-19.

Sadeghipour, P et al. Effect of Intermediate-Dose vs Standard-Dose Prophylactic Anticoagulation on Thrombotic Events, Extracorporeal Membrane Oxygenation Treatment, or Mortality Among Patients With COVID-19 Admitted to the Intensive Care Unit. JAMA. https://doi.org/10.1001/jama.2021.4152