Anticoagulation in Patients With COVID-19: JACC Review Topic of the Week.
J Am Coll Cardiol
; 79(9): 917-928, 2022 03 08.
Article
in En
| MEDLINE
| ID: mdl-35241226
ABSTRACT
Clinical, laboratory, and autopsy findings support an association between coronavirus disease-2019 (COVID-19) and thromboembolic disease. Acute COVID-19 infection is characterized by mononuclear cell reactivity and pan-endothelialitis, contributing to a high incidence of thrombosis in large and small blood vessels, both arterial and venous. Observational studies and randomized trials have investigated whether full-dose anticoagulation may improve outcomes compared with prophylactic dose heparin. Although no benefit for therapeutic heparin has been found in patients who are critically ill hospitalized with COVID-19, some studies support a possible role for therapeutic anticoagulation in patients not yet requiring intensive care unit support. We summarize the pathology, rationale, and current evidence for use of anticoagulation in patients with COVID-19 and describe the main design elements of the ongoing FREEDOM COVID-19 Anticoagulation trial, in which 3,600 hospitalized patients with COVID-19 not requiring intensive care unit level of care are being randomized to prophylactic-dose enoxaparin vs therapeutic-dose enoxaparin vs therapeutic-dose apixaban. (FREEDOM COVID-19 Anticoagulation Strategy [FREEDOM COVID]; NCT04512079).
Key words
Full text:
1
Collection:
01-internacional
Health context:
4_TD
Database:
MEDLINE
Main subject:
Thromboembolism
/
Thrombosis
/
COVID-19
/
Anticoagulants
Type of study:
Clinical_trials
/
Observational_studies
Limits:
Humans
Language:
En
Journal:
J Am Coll Cardiol
Year:
2022
Document type:
Article