Full-Dose Clot Prophylaxis for COVID-19 Tied to Mortality, f
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Preemptive therapeutic-dose anticoagulation for patients hospitalized with COVID-19 wasn't linked to better outcomes in a small observational study.

This study is the first of its kind to assess the impact of preemptive therapeutic dose anticoagulation on mortality compared to prophylactic anticoagulation among COVID-19 patients. Its findings provide insight to clinicians regarding the management of COVID-19, particularly with the known prothrombotic state.

This study aimed to determine the impact of anticoagulation on in-hospital mortality among COVID-19 positive patients with the a priori hypothesis that there would be a lower risk of in hospital mortality with use of preemptive therapeutic over prophylactic dose enoxaparin or heparin.

A Retrospective cohort study was carried out. Five hundred and one inpatients were identified after discharge as 18 years or older 35 and positive for SARS-CoV-2. The final sample size included 374 patients after applying 36 exclusion criteria. Preemptive enoxaparin or heparin at a therapeutic or prophylactic dose was administered. The main outcome was In-hospital mortality.

When comparing preemptive therapeutic to prophylactic anticoagulation through multi variable analysis, risk of in-hospital mortality was 2.3 times greater in patients receiving preemptive therapeutic anticoagulation.

Conclusively, An increase in in-hospital mortality was observed with preemptive therapeutic anticoagulation. Thus, in the management of COVID-19 and its complications, researchers recommend further research and cautious use of preemptive therapeutic over prophylactic anticoagulation.

Source: https://www.medrxiv.org/content/medrxiv/early/2020/07/26/2020.07.20.20147769.full.pdf
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