Heparin Dose Intensity and Organ Support-Free Days in Patients Hospitalized for COVID-19
Primary result · OSFDs, noncritically ill per-protocol patientsResult — go to the resultMedian adjusted odds ratio 1.36 95% CrI 1.07–1.74Authors' conclusion
Among noncritically ill patients hospitalized for COVID-19 who were randomized to and initially received therapeutic-dose anticoagulation, heparin, compared with usual care, was associated with improved OSFDs, a combination of in-hospital death and days free of organ support. Therapeutic heparin appeared superior to both low- and intermediate-dose thromboprophylaxis.
Study context
- Population
- Patients hospitalised for COVID-19 (noncritically and critically ill) who received initial anticoagulation dosed consistently with randomisation
- Participants
- 2,860 patients
- Comparison
- Therapeutic-dose heparin vs usual care
- Primary endpoint
- Organ support-free days (combination of in-hospital death and days free of organ support)
- Follow-up
- Through day 21
Methodological detailsprespecified per-protocol analysis, exploratory dose-based analysis, 1,761 (92.8%) noncritically ill and 857 (89.1%) critically ill patients treated per-protocol
- Prespecified per-protocol analysis
- Exploratory dose-based analysis
- 1,761 (92.8%) noncritically ill and 857 (89.1%) critically ill patients treated per-protocol
Primary result
Organ support-free days (OSFDs), noncritically ill per-protocol patients
Median adjusted odds ratio
1.36
95% CrI 1.07–1.74
Therapeutic-dose heparinvs Usual care
median adjusted OR 1.36 (95% CrI 1.07–1.74)
As reported in the abstract
Further findings
| Outcome | Adjusted OR (95% CrI) | |
|---|---|---|
| OSFDs by dose (exploratory dose-based analysis), noncritically illTherapeutic-dose heparinvs Low-dosePosterior probability of efficacy 94.6%; CrI · CrI | 1.26 (0.95–1.64) | |
| OSFDs by dose (exploratory dose-based analysis), noncritically illTherapeutic-dose heparinvs Intermediate-dosePosterior probability of efficacy 99.8%; CrI · CrI | 1.80 (1.22–2.62) | |
| 0.20.5125Adjusted odds ratio (log scale) |
Original publication
Heparin Dose Intensity and Organ Support-Free Days in Patients Hospitalized for COVID-19. JACC Adv. Published 26 January 2024. doi:10.
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