Anticoagulant interventions in hospitalized patients with COVID‐19: A scoping review of randomized controlled trials and call for international collaboration

Abstract

Introduction: Coronavirus disease (COVID-19) is associated with a high incidence of thrombosis and mortality despite standard anticoagulant thromboprophylaxis. There is equipoise regarding the optimal dose of anticoagulant intervention in hospitalized patients with COVID-19 and consequently, immediate answers from high-quality randomized trials are needed. Methods: The World Health Organization's International Clinical Trials Registry Platform was searched on June 17, 2020 for randomized controlled trials comparing increased dose to standard dose anticoagulant interventions in hospitalized COVID-19 patients. Two authors independently screened the full records for eligibility and Study acronym or PI Trial ID Source registry Countries Date of registration Estimated study completion date COVID-HEP NCT04345848 ClinicalTrials.gov Switzerland

High rates of pulmonary artery occlusions in COVID‐19. A meta‐analysis

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“…• Virus entry into cells upon spike protein cleavage by a serine protease transmembrane protease serine subtype 2 (TMPRSS2 19,20 Anticoagulant Treatment: Direct Oral Anticoagulants COVID-19 symptoms and thrombotic-inflammatory processes start days after initial infection with SARS-CoV-2, when patients are not hospitalized. 21 Upon hospitalization, low dose apixaban (odds ratio [OR] 0.46, p ¼ 0.001), therapeutic dose apixaban (OR 0.57, p ¼ 0.006), and enoxaparin prophylaxis (OR 0.49, p ¼ 0.001) have all been associated with a significant decrease in mortality of hospitalized COVID-19 patients.…”

Goodbye 2020, hello to our future

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