ArticleJournal of thrombosis and haemostasis : JTH2021
Bleeding risk by intensity of anticoagulation in critically ill patients with COVID-19: A retrospective cohort study.
Article in Journal of thrombosis and haemostasis : JTH, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 5 of them syntheses that pooled it.
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Who cites it
21 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- American Society of Hematology living guidelines on use of anticoagulation for thromboprophylaxis for patients with COVID-19: executive summary.Blood advances · 2025Guideline
- Efficacy of different anticoagulant doses for patients with COVID-19: a systematic review and network meta-analysis.Infection · 2022Pooled it
- Guideline
- Prevention of venous thromboembolism and haemostasis monitoring in patients with COVID-19: Updated proposals (April 2021): From the French working group on perioperative haemostasis (GIHP) and the French study group on thrombosis and haemostasis (GFHT), in collaboration with the French society of anaesthesia and intensive care (SFAR).Anaesthesia, critical care & pain medicine · 2021Guideline
- Efficacy and Safety of Direct Oral Anticoagulants Compared With Heparin for Preventing Thromboembolism in Hospitalized Patients With COVID-19: A Systematic Review and Meta-Analysis.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisPooled it
- Trial
- Article
- Bleeding and thrombotic events and intensity of heparin therapy in the two first waves of COVID-19.Internal and emergency medicine · 2024Article
- Major Bleeding Events in Hospitalized COVID-19 Patients: A Retrospective Observational Study.Medicina (Kaunas, Lithuania) · 2024Observational
- A Multicenter Study Assessing the Optimal Anticoagulation Strategies in COVID-19 Critically Ill Patients with New-Onset Atrial Fibrillation: Balancing Effectiveness and Safety.International journal of general medicine · 2024Article
- Case Report: Spontaneous Left Inferior Epigastric Artery Injury in a COVID-19 Female Patient Undergoing Anticoagulation Therapy.Journal of clinical medicine · 2023Article
- Incidence, risk factors, and clinical impact of major bleeding in hospitalized patients with COVID-19: a sub-analysis of the CLOT-COVID Study.Thrombosis journal · 2022Article
- Increased Susceptibility for Thromboembolic Events versus High Bleeding Risk Associated with COVID-19.Microorganisms · 2022Review
- Bleeding and thrombotic events in patients with severe COVID-19 supported with extracorporeal membrane oxygenation: a nationwide cohort study.Intensive care medicine · 2022Article
- 3D-PAST: Risk Assessment Model for Predicting Venous Thromboembolism in COVID-19.Journal of clinical medicine · 2022Article
- Subcutaneous Enoxaparin for Systemic Anticoagulation of COVID-19 Patients During Extracorporeal Life Support.Frontiers in medicine · 2022Article
- Intermediate-to-therapeutic versus prophylactic anticoagulation for coagulopathy in hospitalized COVID-19 patients: a systemic review and meta-analysis.Thrombosis journal · 2021Article
- Remote history of VTE is associated with severe COVID-19 in middle and older age: UK Biobank cohort study.Journal of thrombosis and haemostasis : JTH · 2021Article
- Bleeding risk in hospitalized patients with COVID-19 receiving intermediate- or therapeutic doses of thromboprophylaxis.Journal of thrombosis and haemostasis : JTH · 2021Article
- Validation of the PESI Scale to Predict in-Hospital Mortality in Patients with Pulmonary Thromboembolism Secondary to SARS CoV - 2 Infection.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisArticle
Corrections and comments
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Authors and funding
17 authors.
Funding
Abstract
backgroundStudies report hypercoagulability in coronavirus disease 2019 (COVID-19), leading many institutions to escalate anticoagulation intensity for thrombosis prophylaxis.
objectiveTo determine the bleeding risk with various intensities of anticoagulation in critically ill patients with COVID-19 compared with other respiratory viral illnesses (ORVI). PATIENTS/
methodsThis retrospective cohort study compared the incidence of major bleeding in patients admitted to an intensive care unit (ICU) within a single health system with COVID-19 versus ORVI. In the COVID-19 cohort, we assessed the effect of anticoagulation intensity received on ICU admission on bleeding risk. We performed a secondary analysis with anticoagulation intensity as a time-varying covariate to reflect dose changes after ICU admission.
resultsFour hundred and forty-three and 387 patients were included in the COVID-19 and ORVI cohorts, respectively. The hazard ratio of major bleeding for the COVID-19 cohort relative to the ORVI cohort was 1.26 (95% confidence interval [CI]: 0.86-1.86). In COVID-19 patients, an inverse-probability treatment weighted model found therapeutic-intensity anticoagulation on ICU admission had an adjusted hazard ratio of bleeding of 1.55 (95% CI: 0.88-2.73) compared with standard prophylactic-intensity anticoagulation. However, when anticoagulation was assessed as a time-varying covariate and adjusted for other risk factors for bleeding, the adjusted hazard ratio for bleeding on therapeutic-intensity anticoagulation compared with standard thromboprophylaxis was 2.59 (95% CI: 1.20-5.57).
conclusionsCritically ill patients with COVID-19 had a similar bleeding risk as ORVI patients. When accounting for changes in anticoagulation that occurred in COVID-19 patients, therapeutic-intensity anticoagulation was associated with a greater risk of major bleeding compared with standard thromboprophylaxis.
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