Observational studyInternal and emergency medicine2021
Increasing dosages of low-molecular-weight heparin in hospitalized patients with Covid-19.
Observational study in Internal and emergency medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 2 of them syntheses 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
29 citing papers in PubMed, 2 syntheses or guidelines pooled it, 59 citations in OpenAlex.
- Efficacy and safety of two heparin regimens for prevention of venous thromboembolism in hospitalized patients with COVID-19: a meta-analysis.Internal and emergency medicine · 2023Pooled it
- Efficacy of different anticoagulant doses for patients with COVID-19: a systematic review and network meta-analysis.Infection · 2022Pooled it
- Involvement of the contact pathway in COVID-19 coagulopathy.Internal and emergency medicine · 2026Article
- Bleeding and thrombotic events and intensity of heparin therapy in the two first waves of COVID-19.Internal and emergency medicine · 2024Article
- Efficacy and safety of safflower yellow combined with low molecular weight heparin in preventing deep vein thrombosis after orthopedic surgery: a systematic review and meta-analysis.American journal of translational research · 2024Article
- Non-Anticoagulant Activities of Low Molecular Weight Heparins-A Review.Pharmaceuticals (Basel, Switzerland) · 2023Review
- Review
- Low Molecular Weight Heparin, Anti-inflammatory/Immunoregulatory and Antiviral Effects, a Short Update.Cardiovascular drugs and therapy · 2023Review
- Comparing Therapeutic versus Prophylactic Enoxaparin Therapy in Severe COVID-19 Patients: A Randomized Clinical Trial.Medical journal of the Islamic Republic of Iran · 2023Article
- Low molecular weight heparin in COVID-19: benefits and concerns.Frontiers in pharmacology · 2023Review
- Comparison between the first and second COVID-19 waves in Internal Medicine wards in Milan, Italy: a retrospective observational study.Internal and emergency medicine · 2022Observational
- Thromboprophylaxis with standard-dose vs. flexible-dose heparin for hospitalized COVID-19 patients: a target trial emulation.Journal of clinical epidemiology · 2022Article
- Clinical evaluation of the safety and efficacy of enoxaparin in patients with COVID-19.Blood transfusion = Trasfusione del sangue · 2022Article
- Obesity and Coronavirus Disease 2019.Journal of translational internal medicine · 2022Article
- The optimal anticoagulation strategy for COVID-19, prophylactic or therapeutic?: a meta-analysis, trial sequential analysis, and meta-regression of more than 27,000 participants.Emergency and critical care medicine · 2022Article
- Effect of therapeutic versus prophylactic anticoagulation therapy on clinical outcomes in COVID-19 patients: a systematic review with an updated meta-analysis.Thrombosis journal · 2022Article
- Coronavirus Disease 2019-Associated Coagulopathy.Microorganisms · 2022Review
- Effects of low molecular weight heparin and fondaparinux on mortality, hemorrhagic and thrombotic complications in COVID-19 patients.Therapeutic advances in neurological disorders · 2022Article
- A comparison of three thromboprophylaxis regimens in critically ill COVID-19 patients: An analysis of real-world data.Frontiers in cardiovascular medicine · 2022Article
- Prophylactic versus therapeutic dose anticoagulation effects on survival among critically ill patients with COVID-19.PloS one · 2022Article
Corrections and comments
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Authors and funding
15 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
We conducted an observational cohort study in adult patients consecutively admitted for the respiratory illness Covid-19 to our hub hospital from March 9 to April 7, 2020. The high observed rate of venous thromboembolism prompted us to increase the prophylactic doses of enoxaparin from 40 mg daily up to 1 mg/kg twice daily in patients admitted to intensive care units (ICU), 0.7 mg/kg twice daily in high-intensity of care wards and 1 mg/kg daily in low-intensity of care wards. Patients on high enoxaparin doses were compared to those who received prophylaxis with the standard dosage. Efficacy endpoints were mortality, clinical deterioration, and the occurrence of venous thromboembolism, safety endpoint was the occurrence of major bleeding. Of 278 patients with Covid-19, 127 received prophylaxis with high enoxaparin doses and 151 with standard dosage. At 21 days, the incidence rate of death and clinical deterioration were lower in patients on higher doses than in those on the standard dosage (hazard ratio 0.39, 95% confidence interval 0.23-0.62), and the incidence of venous thromboembolism was also lower (hazard ratio 0.52, 95% confidence interval 0.26-1.05). Major bleeding occurred in four of 127 patients (3.1%) on the high enoxaparin dosage. In conclusion, in the cohort of patients with Covid-19 treated with high enoxaparin dosages we observed a 60% reduction of mortality and clinical deterioration and a 50% reduction of venous thromboembolism compared to standard dosage prophylaxis. However, 3% of patients on high enoxaparin dosages had non-fatal major bleeding.
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