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Therapeutic Anticoagulation in hospitalized COVID-19 patients

ATTACC, ACTIV-4a and REMAP-CAP teams publish results in the New England Journal of Medicine from two RCTs addressing therapeutic anticoagulation in hospitalized COVID-19 patients



Therapeutic Anticoagulation in Hospitalized Critically Ill and Non-Critically Ill Patients with COVID-19
 
Congratulations to the ATTACC, ACTIV-4a and REMAP-CAP teams for publication of results from two RCTs in the New England Journal of Medicine. This work builds on many years of experience investigating the impact of anticoagulation in acutely ill patients with infection.
 
This multiplatform trial has found that:
 
  • In non-critically ill patients hospitalized with COVID-19, therapeutic-dose anticoagulation with heparin/low molecular weight heparin improves survival to hospital discharge with reduced use of ICU-level organ support
  • In critically ill patients with COVID-19 (on organ support at baseline), therapeutic-dose anticoagulation with heparin/low molecular weight heparin is inferior to usual-care thromboprophylaxis
 
This multiplatform RCT has provided a wonderful example of conducting randomized trials where independent platforms can operate independently but contribute patient-level data collaboratively to speed knowledge generation and enhance generalizability. Congratulations to Ryan, Ewan, Patrick and the entire ATTACC, ACTIV-4a and REMAP-CAP teams.