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Meta-analysis
Comparison of safety and efficacy between therapeutic or intermediate versus prophylactic anticoagulation for thrombosis in COVID-19 patients: a systematic review and meta-analysis
Hyeon-Jeong Lee, Hye Jin Jang, Won-Il Choi, Joonsung Joh, Junghyun Kim, Jungeun Park, Miyoung Choi
Acute Crit Care. 2023;38(4):516-516.   Published online November 28, 2023
DOI: https://doi.org/10.4266/acc.2022.01424.e1
Corrects: Acute Crit Care 2023;38(2):160
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  • 44 Download
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Original Article
Meta-analysis
Comparison of safety and efficacy between therapeutic or intermediate versus prophylactic anticoagulation for thrombosis in COVID-19 patients: a systematic review and meta-analysis
Hyeon-Jeong Lee, Hye Jin Jang, Won-Il Choi, Joonsung Joh, Junghyun Kim, Jungeun Park, Miyoung Choi
Acute Crit Care. 2023;38(2):160-171.   Published online May 25, 2023
DOI: https://doi.org/10.4266/acc.2022.01424
Correction in: Acute Crit Care 2023;38(4):516
  • 3,264 View
  • 186 Download
  • 3 Web of Science
  • 2 Crossref
AbstractAbstract PDFSupplementary Material
Background
Patients with coronavirus disease 2019 (COVID-19) infections often have macrovascular or microvascular thrombosis and inflammation, which are known to be associated with a poor prognosis. Heparin has been hypothesized that administration of heparin with treatment dose rather than prophylactic dose for prevention of deep vein thrombosis in COVID-19 patients. Methods: Studies comparing therapeutic or intermediate anticoagulation with prophylactic anticoagulation in COVID-19 patients were eligible. Mortality, thromboembolic events, and bleeding were the primary outcomes. PubMed, Embase, the Cochrane Library, and KMbase were searched up to July 2021. A meta-analysis was performed using random-effect model. Subgroup analysis was conducted according to disease severity. Results: Six randomized controlled trials (RCTs) with 4,678 patients and four cohort studies with 1,080 patients were included in this review. In the RCTs, the therapeutic or intermediate anticoagulation was associated with significant reductions in the occurrence of thromboembolic events (5 studies, n=4,664; relative risk [RR], 0.72; P=0.01), and a significant increase in bleeding events (5 studies, n=4,667; RR, 1.88; P=0.004). In the moderate patients, therapeutic or intermediate anticoagulation was more beneficial than prophylactic anticoagulation in terms of thromboembolic events, but showed significantly higher bleeding events. In the severe patients, the incidence of thromboembolic and bleeding events in the therapeutic or intermediate. Conclusions: The study findings suggest that prophylactic anticoagulant treatment should be used in patients with moderate and severe COVID-19 infection groups. Further studies are needed to determine more individualized anticoagulation guidance for all COVID-19 patients.

Citations

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  • The Community Pharmacy as a Study Center for the Epidemiological Analysis of the Population Vaccination against SARS-CoV-2: Evaluation of Vaccine Safety and Pharmaceutical Service
    Jacopo Raffaele Dibenedetto, Michela Cetrone, Marina Antonacci, Domenico Pio Cannone, Stefania Antonacci, Pasquale Bratta, Francesco Leonetti, Domenico Tricarico
    Pharmacy.2024; 12(1): 16.     CrossRef
  • Specific and Non-specific Aspects and Future Challenges of ICU Care Among COVID-19 Patients with Obesity: A Narrative Review
    Alexandra Beurton, Emma J. Kooistra, Audrey De Jong, Helmut Schiffl, Mercedes Jourdain, Bruno Garcia, Damien Vimpère, Samir Jaber, Peter Pickkers, Laurent Papazian
    Current Obesity Reports.2024; 13(3): 545.     CrossRef

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