Related Experiment Video
Updated: Jun 28, 2025
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
Characterization of the Benefits and Risks of Therapeutic Anticoagulation in Patients Admitted with Severe COVID-19
Alison Jinn1, Michael Kammermayer2, Vincent H Mabasa3
1, BSc(Pharm), ACPR, was, at the time of this study, a Postgraduate Year 1 Resident with Lower Mainland Pharmacy Services, Fraser Health Authority, Burnaby, British Columbia. She is now a Clinical Pharmacist with the Pharmacy Department, Royal Columbian Hospital, New Westminster, British Columbia.
Insights
Therapeutic anticoagulation for severe COVID-19 patients at low bleeding risk showed low rates of major bleeding and thrombotic events. This approach may be safe and effective for hospitalized patients.
Area of Science:
- Internal Medicine
- Critical Care Medicine
- Infectious Diseases
Background:
- Severe COVID-19 is linked to increased thrombotic complications.
- Provincial guidelines suggest therapeutic anticoagulation for severe COVID-19 inpatients with low bleeding risk.
- This study evaluates the safety and efficacy of this recommendation.
Purpose of the Study:
- To assess rates of major bleeding and thrombotic events in severe COVID-19 patients receiving therapeutic anticoagulation.
- To characterize COVID-19 complications and adverse effects in this patient cohort.
- To evaluate the safety profile of therapeutic anticoagulation in severe COVID-19.
Main Methods:
- Retrospective chart review of laboratory-confirmed COVID-19 inpatients.
- Inclusion criteria: severe COVID-19, therapeutic anticoagulation for thromboprophylaxis, low bleeding risk.
- Data collected on bleeding events, thrombotic events, COVID-19 progression, and adverse effects.
Main Results:
- 72 patients included; mean age 54, 63% male.
- Major bleeding occurred in 1% (1 patient).
- Thrombotic events in 1% (1 patient); 15% required increased oxygen, 7% ICU admission; 1 death.
Conclusions:
- Therapeutic anticoagulation in severe COVID-19 patients at low bleeding risk demonstrated low rates of major bleeding and thrombotic events.
- The findings support the use of therapeutic anticoagulation in selected hospitalized COVID-19 patients.
- This treatment strategy appears safe and effective for preventing thrombotic complications.
Background:
Severe COVID-19 is associated with increased rates of thrombotic complications. Recent provincial recommendations in British Columbia have suggested providing thromboprophylaxis with therapeutic anticoagulation for hospital inpatients with severe COVID-19 who do not have a high risk of bleeding.
Objectives:
To characterize the rates of major bleeding, thrombotic events, complications from COVID-19, and adverse effects among patients with severe COVID-19 treated with therapeutic anticoagulation.
Methods:
This retrospective chart review involved patients with laboratory-confirmed COVID-19 who were admitted to 3 sites within a local health authority between April 1 and December 31, 2021, and received therapeutic anticoagulation for thromboprophylaxis.
Results:
After screening of 1036 patients, 72 patients were included in the study. The mean age of participants was 54 years, 63% (n = 45) were male, and 92% (n = 66) were receiving supplemental oxygen by nasal prongs on admission. The primary outcome, major bleeding, was experienced by 1 patient (1%). Increasing oxygen requirements resulting in progression to high-flow nasal cannula occurred in 11 patients (15%), and 5 patients (7%) required admission to the intensive care unit. One patient (1%) experienced a thrombotic event, and 1 patient (1%) had a minor bleed. The mean duration of hospitalization was 10 (standard deviation 10.8) days. One death occurred during the study period, and no cases of heparin-induced thrombocytopenia were observed.
Conclusions:
In this study of hospital inpatients with severe COVID-19 who were deemed to be at low risk of bleeding and who received therapeutic anticoagulation, there were low rates of both major bleeding and thrombotic events.
Related Concept Videos
01:18Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
01:20Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
01:13Therapeutic Index
01:24Disorders of Hemostasis
Thromboembolic Disorders
Two factors primarily cause thromboembolic conditions.
01:18Cardiovascular Drugs: Classification based on Therapeutic Indications