ArticleResearch and practice in thrombosis and haemostasis2021
Randomized trials of therapeutic heparin for COVID-19: A meta-analysis.
Article in Research and practice in thrombosis and haemostasis, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 5 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, 5 syntheses or guidelines pooled it.
- Therapeutic-dose anticoagulation or thromboprophylaxis with low-molecular-weight heparin for moderate Covid-19: meta-analysis of randomized controlled trials.Clinical and experimental medicine · 2023Pooled it
- Pooled it
- 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 and safety of heparin full-dose anticoagulation in hospitalized non-critically ill COVID-19 patients: a meta-analysis of multicenter randomized controlled trials.Journal of thrombosis and thrombolysis · 2022Pooled it
- FullHaematologica · 2022Pooled it
- Therapeutic-dose heparin combined with antiplatelets in noncritically ill patients with COVID-19: a secondary analysis of a multiplatform randomized controlled trial.Research and practice in thrombosis and haemostasis · 2025Article
- Primary thromboprophylaxis in ambulatory symptomatic patients with COVID-19: a systematic review and meta-analysis of randomized controlled trials.Research and practice in thrombosis and haemostasis · 2024Article
- Heparin Dose Intensity and Organ Support-Free Days in Patients Hospitalized for COVID-19.JACC. Advances · 2024Article
- Estrogen-based hormonal therapy and the risk of thrombosis in COVID-19 patients.European journal of haematology · 2023Article
- D-dimer and Beyond: Harnessing the Potential of New Coagulation Indicators in COVID-19 Management.Internal medicine (Tokyo, Japan) · 2023Article
- Cerebrovascular Disease in COVID-19.Viruses · 2023Review
- Evaluation of a fast-and-frugal clinical decision algorithm ('pathways') on clinical outcomes in hospitalised patients with COVID-19 treated with anticoagulants.Journal of evaluation in clinical practice · 2023Observational
- The diverse role of heparan sulfate and other GAGs in SARS-CoV-2 infections and therapeutics.Carbohydrate polymers · 2023Review
- Article
- Dysregulated thrombospondin 1 and miRNA-29a-3p in severe COVID-19.Scientific reports · 2022Article
- COVID-19: ACT trials for colchicine and antithrombotic therapies.The Lancet. Respiratory medicine · 2022Article
- "ISTH guidelines for antithrombotic treatment in COVID-19": Reply.Journal of thrombosis and haemostasis : JTH · 2022Article
- ISTH guidelines for antithrombotic treatment in COVID-19.Journal of thrombosis and haemostasis : JTH · 2022Article
- Article
- Article
Corrections and comments
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Authors and funding
20 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPulmonary endothelial injury and microcirculatory thromboses likely contribute to hypoxemic respiratory failure, the most common cause of death, in patients with COVID-19. Randomized controlled trials (RCTs) suggest differences in the effect of therapeutic heparin between moderately and severely ill patients with COVID-19. We did a systematic review and meta-analysis of RCTs to determine the effects of therapeutic heparin in hospitalized patients with COVID-19.
methodsWe searched PubMed, Embase, Web of Science, medRxiv, and medical conference proceedings for RCTs comparing therapeutic heparin with usual care, excluding trials that used oral anticoagulation or intermediate doses of heparin in the experimental arm. Mantel-Haenszel fixed-effect meta-analysis was used to combine odds ratios (ORs). RESULTS AND
conclusionsThere were 3 RCTs that compared therapeutic heparin to lower doses of heparin in 2854 moderately ill ward patients, and 3 RCTs in 1191 severely ill patients receiving critical care. In moderately ill patients, there was a nonsignificant reduction in all-cause death (OR, 0.76; 95% CI, 0.57-1.02), but significant reductions in the composite of death or invasive mechanical ventilation (OR, 0.77; 95% CI, 0.60 0.98), and death or any thrombotic event (OR, 0.58; 95% CI, 0.45-0.77). Organ support-free days alive (OR, 1.29; 95% CI, 1.07-1.57) were significantly increased with therapeutic heparin. There was a nonsignificant increase in major bleeding. In severely ill patients, there was no evidence for benefit of therapeutic heparin, with significant treatment-by-subgroup interactions with illness severity for all-cause death (
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