ArticleWorld journal of emergency surgery : WJES2020
Salvage use of tissue plasminogen activator (tPA) in the setting of acute respiratory distress syndrome (ARDS) due to COVID-19 in the USA: a Markov decision analysis.
Article in World journal of emergency surgery : WJES, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 36 citations in OpenAlex.
- Clinical determinants of the severity of COVID-19: A systematic review and meta-analysis.PloS one · 2021Pooled it
- Causal Effects of COVID-19 on the Risk of Thrombosis: A Two-Sample Mendel Randomization Study.Thrombosis and haemostasis · 2024Article
- Fibrinolytic system and COVID-19: From an innovative view of epithelial ion transport.Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie · 2023Review
- A narrative review of COVID-19-related acute respiratory distress syndrome (CARDS): "typical" or "atypical" ARDS?Annals of translational medicine · 2022Review
- Pharmacotherapy consideration of thrombolytic medications in COVID-19-associated ARDS.Journal of intensive care · 2022Review
- Coagulopathy and Fibrinolytic Pathophysiology in COVID-19 and SARS-CoV-2 Vaccination.International journal of molecular sciences · 2022Review
- COVID-19 and thrombotic complications-the role of anticoagulants, antiplatelets and thrombolytics.Journal of family medicine and primary care · 2021Review
- Do inflammaging and coagul-aging play a role as conditions contributing to the co-occurrence of the severe hyper-inflammatory state and deadly coagulopathy during COVID-19 in older people?Experimental gerontology · 2021Review
- Fibrinolysis Shutdown in COVID-19: Clinical Manifestations, Molecular Mechanisms, and Therapeutic Implications.Journal of the American College of Surgeons · 2021Review
- Thrombosis and Haemostasis challenges in COVID-19 - Therapeutic perspectives of heparin and tissue-type plasminogen activator and potential toxicological reactions-a mini review.Food and chemical toxicology : an international journal published for the British Industrial Biological Research Association · 2021Review
- The Central Role of Fibrinolytic Response in COVID-19-A Hematologist's Perspective.International journal of molecular sciences · 2021Review
- COVID-19-associated coagulopathy and disseminated intravascular coagulation.International journal of hematology · 2021Review
- Current directions, conceptions and viewpoints on 2019-nCoV (Review).Experimental and therapeutic medicine · 2021Review
- COVID-19-Associated Coagulopathy and Inflammatory Response: What Do We Know Already and What Are the Knowledge Gaps?Anesthesia and analgesia · 2020Review
- Coagulopathy, Venous Thromboembolism, and Anticoagulation in Patients with COVID-19.Pharmacotherapy · 2020Review
- Inhaled and systemic heparin as a repurposed direct antiviral drug for prevention and treatment of COVID-19.Clinical medicine (London, England) · 2020Article
- Clinical efficacy of tocilizumab treatment in severe and critical COVID-19 patients.World journal of clinical cases · 2020Article
- SARS-CoV-2 and cancer: Are they really partners in crime?Cancer treatment reviews · 2020Review
- Thrombosis in Coronavirus disease 2019 (COVID-19) through the prism of Virchow's triad.Clinical rheumatology · 2020Review
- Fibrinolysis Shutdown Correlation with Thromboembolic Events in Severe COVID-19 Infection.Journal of the American College of Surgeons · 2020Article
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundCOVID-19 threatens to quickly overwhelm our existing critical care infrastructure in the USA. Systemic tissue plasminogen activator (tPA) has been previously demonstrated to improve PaO
methodsA decision analytic Markov state transition model was created to simulate the life critically ill COVID-19 patients as they transitioned to either recovery or death. Two patient groups were simulated (50,000 patients in each group); (1) Patients received tPA immediately upon diagnosis of ARDS and (2) patients received standard therapy for ARDS. Base case critically ill COVID-19 patients were defined as having a refractory PaO
resultsThe use of tPA was associated with reduced mortality (47.6% [tTPA] vs. 71.0% [no tPA]) for base case patients. When extrapolated to the projected COVID-19 eligible for salvage use tPA in the USA, peak mortality (deaths/100,000 patients) was reduced for both optimal social distancing (70.5 [tPA] vs. 75.0 [no tPA]) and no social distancing (158.7 [tPA] vs. 168.8 [no tPA]) scenarios.
conclusionsSalvage use of tPA may improve recovery of ARDS patients, thereby reducing COVID-19-related mortality and ensuring sufficient resources to manage this pandemic.
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Registered trials
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