Evidence map›Paper›PMID 35859579›Full record

ArticleResearch and practice in thrombosis and haemostasis2022

Thromboprophylaxis in people hospitalized with COVID-19: Assessing intermediate or standard doses in a retrospective cohort study.

Kathleen M Andersen, Corey S Joseph, Hemalkumar B Mehta, Michael B Streiff, Joshua F Betz, Robert C Bollinger, Arielle M Fisher, Amita Gupta, Charles F LeMaistre, Matthew L Robinson and 4 more

Abstract read
In one paragraph

Article in Research and practice in thrombosis and haemostasis, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Kathleen M AndersenDepartment of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USA.ORCID https://orcid.org/0000-0003-2670-800X
Corey S JosephDepartment of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USA.
Hemalkumar B MehtaDepartment of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USA.
Michael B StreiffDivision of Hematology Johns Hopkins University School of Medicine Baltimore Maryland USA.
Joshua F BetzDepartment of Biostatistics Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USA.
Robert C BollingerDivision of Infectious Diseases Johns Hopkins University School of Medicine Baltimore Maryland USA.
Arielle M FisherSarah Cannon, Genospace, HCA Healthcare Research Institute Nashville Tennessee USA.
Amita GuptaDivision of Infectious Diseases Johns Hopkins University School of Medicine Baltimore Maryland USA.
Charles F LeMaistreSarah Cannon, Genospace, HCA Healthcare Research Institute Nashville Tennessee USA.
Matthew L RobinsonDivision of Infectious Diseases Johns Hopkins University School of Medicine Baltimore Maryland USA.
Yanxun XuDepartment of Applied Mathematics and Statistics Johns Hopkins University Baltimore Maryland USA.
Derek K NgDepartment of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USA.
G Caleb AlexanderDepartment of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USA.
Brian T GaribaldiDivision of Pulmonary and Critical Care Medicine Johns Hopkins University School of Medicine Baltimore Maryland USA.

Funding

The Johns Hopkins Baltimore-Washington-India Clinical Trials Unit (BWI CTU)UM1AI069465 · NIAID · JOHNS HOPKINS UNIVERSITY · PI Charles W. Flexner, Amita Gupta · 2012 to 2026
$34.1M
NHLBI Training Program in PharmacoepidemiologyT32HL139426 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI G. Caleb Alexander, JODI B. SEGAL · 2018 to 2026
$2.5M
Drug-Drug Interactions Involving Direct-Acting Oral Anticoagulants in Nursing Home ResidentsK01AG070329 · NIA · JOHNS HOPKINS UNIVERSITY · PI MEHTA, HEMALKUMAR B. · 2021 to 2025
$647k
NHLBI NIH HHS T32 HL139426NIAID NIH HHS UM1 AI069465NIA NIH HHS K01 AG070329
6 · The paper itself

Abstract

Background and Objectives: Current clinical guidelines recommend thromboprophylaxis for adults hospitalized with coronavirus disease 2019 (COVID-19), yet it is unknown whether higher doses of thromboprophylaxis offer benefits beyond standard doses. Methods: We studied electronic health records from 50 091 adults hospitalized with COVID-19 in the United States between February 2020 and February 2021. We compared standard (enoxaparin 30 or 40 mg/day, fondaparinux 2.5 mg, or heparin 5000 units twice or thrice per day) versus intermediate (enoxaparin 30 or 40 mg twice daily, or up to 1.2 mg/kg of body weight daily, heparin 7500 units thrice per day or heparin 10 000 units twice or thrice per day) thromboprophylaxis. We separately examined risk of escalation to therapeutic anticoagulation, severe disease (first occurrence of high-flow nasal cannula, noninvasive positive pressure ventilation or invasive mechanical ventilation), and death. To summarize risk, we present hazard ratios (HRs) with 95% confidence intervals (CIs) using adjusted time-dependent Cox proportional hazards regression models. Results: People whose first dose was high intensity were younger, more often obese, and had greater oxygen support requirements. Intermediate dose thromboprophylaxis was associated with increased risk of therapeutic anticoagulation (HR, 3.39; 95% CI, 3.22-3.57), severe disease (HR, 1.22; 95% CI, 1.17-1.28), and death (HR, 1.37; 95% CI, 1.21-1.55). Increased risks associated with intermediate-dose thromboprophylaxis persisted in subgroup and sensitivity analyses varying populations and definitions of exposures, outcomes, and covariates. Conclusions: Our findings do not support routine use of intermediate-dose thromboprophylaxis to prevent clinical worsening, severe disease, or death among adults hospitalized with COVID-19.

Indexed as

COVID‐19enoxaparinheparinpharmacoepidemiologySARS‐CoV‐2

Identifiers

PMID35859579
PMCPMC9287673

What OpenQuestion holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.