ArticleCureus2024
Step-Based Dosing of Anticoagulants in COVID-19 Treatment.
Article in Cureus, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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.
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.
Who cites it
1 citing paper in PubMed.
- Concerns and recommendations: antiplatelet agents and cancer prevention in non-alcoholic fatty liver disease.Frontiers in oncology · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundStep-based dosing of anticoagulants has been widely implemented for the treatment of coronavirus disease 2019 (COVID-19), but no studies have comprehensively evaluated the effectiveness and safety of this approach. We aimed to investigate whether step-based dosing of anticoagulants was associated with clinical outcomes in patients with COVID-19 compared with standard prophylactic dosing.
methodWe conducted a retrospective cohort study on adults hospitalized with moderate-to-severe COVID-19. The exposure was step-based dosing of anticoagulants, including prophylactic anticoagulants (PrA), prophylactic-switching-to-therapeutic anticoagulants (Pr-to-ThA), therapeutic anticoagulants (ThA), and therapeutic-switching-to-prophylactic anticoagulants (Th-to-PrA). The primary effectiveness outcome was a composite of all-cause mortality, admission to an intensive care unit (ICU admission), stroke, and venous thromboembolism (VTE). The primary safety outcome was a composite of major and minor/clinically relevant non-major (CRNM) bleeding.
resultsAmong 1,081 records for analysis (mean age 59.9, 49.9% being female), during a median follow-up of 15 days, the primary effectiveness outcome occurred in 333 patients (33.5% in the PrA group, 24.6% in the Pr-to-ThA group, 23.7% in the Th-to-PrA group, and 38.0% in the ThA group). Compared with the PrA group, patients receiving Pr-to-ThA had a lower risk of the primary effectiveness outcome (adjusted odds ratio (OR) 0.64, 95% CI: 0.45 to 0.90, Dunnett-adjusted p = 0.01), while those in the Th-to-PrA and ThA were more likely to experience the primary safety outcome (Th-to-PrA, aOR = 3.00, 95% CI: 1.53 to 5.89; ThA, aOR = 3.05, 95% CI: 1.61 to 5.79).
conclusionIn adults hospitalized with moderate-to-severe COVID-19, compared with standard PrA, the step-based dose-increasing therapy was associated with a lower composite risk of all-cause mortality, ICU admission, stroke, or VTE without evidence of a higher risk of bleeding. ThA dosing was associated with an increase in the bleeding risk, primarily minor and CRNM bleeding.
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