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Rapid Point-of-Care Assay of Enoxaparin Anticoagulant Efficacy in Whole Blood
11:17

Rapid Point-of-Care Assay of Enoxaparin Anticoagulant Efficacy in Whole Blood

Published on: October 12, 2012

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Standard prophylactic versus intermediate dose enoxaparin in adults with severe COVID-19: A multi-center, open-label,

Usha S Perepu1, Isaac Chambers1, Abdul Wahab1

  • 1Department of Internal Medicine, University of Iowa, Iowa City, Iowa, USA.

Journal of Thrombosis and Haemostasis : JTH
|July 8, 2021
PubMed

Insights

For severe COVID-19 patients, intermediate-dose enoxaparin did not significantly reduce 30-day mortality or thrombosis compared to standard prophylactic doses. Both treatments showed similar efficacy and safety profiles in this hospitalized group.

Area of Science:

  • Critical Care Medicine
  • Pharmacology
  • Infectious Diseases

Background:

  • Hospitalized patients with Coronavirus disease 2019 (COVID-19) often experience coagulopathy.
  • Optimal prophylactic anticoagulation therapy for COVID-19 remains uncertain and may vary with disease severity.

Purpose of the Study:

  • To compare outcomes in hospitalized adults with severe COVID-19 receiving standard prophylactic versus intermediate-dose enoxaparin.
  • To evaluate the efficacy and safety of different enoxaparin dosing strategies in severe COVID-19.

Main Methods:

  • A multi-center, open-label, randomized controlled trial was conducted.
  • 176 hospitalized adults with severe COVID-19 were randomized 1:1 to standard prophylactic or intermediate weight-adjusted dose enoxaparin.
  • Primary outcome was 30-day all-cause mortality; secondary outcomes included thromboembolism and major bleeding.

Main Results:

  • 30-day all-cause mortality was 15% for intermediate dose and 21% for standard dose enoxaparin (P=0.31).
  • No significant difference in mortality was observed between the groups (HR, 0.67; 95% CI, 0.33-1.37).
  • Arterial or venous thrombosis occurred in 13% of the intermediate-dose group and 9% of the standard-dose group; major bleeding occurred in 2% of each group.

Conclusions:

  • Standard prophylactic and intermediate doses of enoxaparin did not significantly differ in preventing death or thrombosis in hospitalized adults with severe COVID-19 at 30 days.
  • The findings suggest that intermediate-dose enoxaparin offers no significant advantage over standard prophylactic dosing in this patient population.
Abstract

Keywords:
COVID-19 diseaseanticoagulantblood coagulationenoxaparinthrombosis

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