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Rapid Point-of-Care Assay of Enoxaparin Anticoagulant Efficacy in Whole Blood
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Parenteral and Oral Anticoagulant Treatment for Hospitalized and Post-Discharge COVID-19 Patients: A Systematic

Rahajeng N Tunjungputri1, Erpryta N Tetrasiwi, Nadia A Mulansari

  • 1Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia. ejnelwan@yahoo.com.

Acta Medica Indonesiana
|July 12, 2022
PubMed

Insights

Anticoagulant therapy significantly reduces mortality in hospitalized COVID-19 patients. Therapeutic doses are more beneficial than prophylactic ones, but more research is needed for post-discharge and outpatient use.

Area of Science:

  • Cardiology
  • Hematology
  • Infectious Diseases

Background:

  • Coagulation abnormalities are a hallmark of COVID-19.
  • Hematological societies recommend anticoagulant use in COVID-19 patients.
  • Evidence on anticoagulant benefits and risks in COVID-19 is evolving.

Purpose of the Study:

  • To update evidence on clinical benefits and risks of anticoagulants in COVID-19.
  • To analyze anticoagulation in hospitalized and post-discharge COVID-19 patients.
  • To compare different anticoagulant dosages and their outcomes.

Main Methods:

  • Systematic review and meta-analysis of 32 studies (2,815 citations, 7 RCTs).
  • Inclusion of 33,494 patients.
  • Pooled analysis of dichotomous variables using risk ratio and random-effects model.

Main Results:

  • Anticoagulant use reduced mortality in hospitalized COVID-19 patients (RR 0.55; 95%CI 0.43-0.66).
  • Higher doses of anticoagulants showed greater benefit than prophylactic doses (RR 0.68; 95%CI 0.40-0.96).
  • Mixed results for pre-hospital anticoagulation; no data on post-discharge benefits.

Conclusions:

  • Therapeutic anticoagulation is indicated when thrombosis is present in COVID-19.
  • Anticoagulants decrease mortality in hospitalized COVID-19 patients.
  • Further research on post-discharge and outpatient anticoagulation is warranted.
Abstract

Keywords:
COVID-19VTEanticoagulantthromboprophylaxis

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