Anticoagulation With Heparin Increases Survival In Moderatel
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An initial strategy of therapeutic-dose anticoagulation with heparin in noncritically ill patients with Covid-19 increases the chances of survival, according to a recent study. The strategy also reduced the use of cardiovascular or respiratory organ support versus usual-care thromboprophylaxis.

Moderately ill COVID-19 patients treated with therapeutic-dose anticoagulation with unfractionated or low molecularweight heparin were 27% less likely to need cardiovascular respiratory organ support such as intubation, said Ambarish Pandey, M.D., Assistant Professor of Internal Medicine at UT Southwestern, who served as site investigator and co-author of the study. Moderately ill patients had a 4% increased chance of survival until discharge without requiring organ support with anticoagulants, according to the study involving 2,200 patients.

"The 4% increase in survival to discharge without needing organ support represents a very meaningful clinical improvement in these patients," said Dr. Pandey, a Texas Health Resources Clinical Scholar who specializes in preventive cardiology and heart failure with preserved ejection fraction. "If we treat 1,000 patients who are hospitalized with COVID-19 with moderate illness, an additional 40 patients would have a meaningful improvement in clinical status."

Participating platforms for the study, which defined moderately ill patients as those who did not need intensive care unit-level support, included Antithrombotic Therapy to Ameliorate Complications of COVID-19 (ATTACC); A Multicenter, Adaptive, Randomized Controlled Platform Trial of the Safety and Efficacy of Antithrombotic Strategies in Hospitalized Adults with COVID-19 (ACTIV-4a); and Randomized, Embedded, Multifactorial Adaptive Platform Trial for Community-Acquired Pneumonia (REMAP-CAP).

Source:
https://www.nejm.org/doi/full/10.1056/NEJMoa2105911
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