THURSDAY, Dec. 26, 2024 (HealthDay News) — For patients hospitalized for COVID-19, administration of therapeutic-dose versus prophylactic-dose anticoagulation with heparins is associated with lower 28-day mortality, according to a review published online Dec. 24 in the Annals of Internal Medicine.
Claire L. Vale, Ph.D., and colleagues from the World Health Organization Rapid Evidence Appraisal for COVID-19 Therapies Working Group, estimated the association of higher-dose versus lower-dose anticoagulation with clinical outcomes for patients hospitalized with COVID-19 using data from 20 eligible trials and two additional studies.
The researchers found that 28-day mortality was reduced with therapeutic-dose versus prophylactic-dose anticoagulation with heparins (odds ratio, 0.77; 95 percent confidence interval, 0.64 to 0.93; 11 trials included 6,297 patients, 5,456 of whom required low or no oxygen at randomization). For 28-day mortality, the odds ratios were 1.21 (95 percent confidence interval, 0.93 to 1.58) for therapeutic-dose versus intermediate-dose anticoagulation and 0.95 (95 percent confidence interval, 0.76 to 1.19) for intermediate- versus prophylactic-dose anticoagulation. Across predefined patient subgroups, treatment effects were broadly consistent; some analyses were limited in power. Fewer thromboembolic events were seen in association with higher- versus lower-dose anticoagulation, but the risk for major bleeding was greater.
“For each comparison, higher- compared with lower-dose anticoagulation was associated with fewer thromboembolic events but a greater risk for major bleeding,” the authors write.
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