Therapeutic-Dose vs. Prophylactic-Dose Anticoagulation Therapy for Critically Ill Patients With COVID-19 in a Practice-Based Observational Study

Yugo Yamashita; Sen Yachi; Makoto Takeyama; Yuji Nishimoto; Ichizo Tsujino; Junichi Nakamura; Naoto Yamamoto; Hiroko Nakata; Satoshi Ikeda; Michihisa Umetsu; Shizu Aikawa; Hiroya Hayashi; Hirono Satokawa; Yoshinori Okuno; Eriko Iwata; Yoshito Ogihara; Nobutaka Ikeda; Akane Kondo; Takehisa Iwai; Norikazu Yamada; Tomohiro Ogawa; Takao Kobayashi; Makoto Mo

doi:10.1253/circj.CJ-22-0209

This article has now been updated. Please use the final version.

Therapeutic-Dose vs. Prophylactic-Dose Anticoagulation Therapy for Critically Ill Patients With COVID-19 in a Practice-Based Observational Study

Yugo Yamashita, Sen Yachi, Makoto Takeyama, Yuji Nishimoto, Ichizo Tsujino, Junichi Nakamura, Naoto Yamamoto, Hiroko Nakata, Satoshi Ikeda, Michihisa Umetsu, Shizu Aikawa, Hiroya Hayashi, Hirono Satokawa, Yoshinori Okuno, Eriko Iwata, Yoshito Ogihara, Nobutaka Ikeda, Akane Kondo, Takehisa Iwai, Norikazu Yamada, Tomohiro Ogawa, Takao Kobayashi, Makoto Mo

Author information

Yugo Yamashita
Kyoto University Hospital [Japan]
Sen Yachi
Japan Community Health Care Organization Tokyo Shinjuku Medical Center [Japan]
Makoto Takeyama
Japan Community Health Care Organization Tokyo Shinjuku Medical Center [Japan]
Yuji Nishimoto
Hyogo Prefectural Amagasaki General Medical Center [Japan]
Ichizo Tsujino
Hokkaido University Hospital [Japan]
Junichi Nakamura
Hokkaido University Hospital [Japan]
Naoto Yamamoto
Hamamatsu Medical Center [Japan]
Hiroko Nakata
Yokosuka General Hospital Uwamachi [Japan]
Satoshi Ikeda
Nagasaki University Graduate School of Biomedical Sciences [Japan]
Michihisa Umetsu
Tohoku University Hospital [Japan]
Shizu Aikawa
Tsukuba Medical Center Hospital [Japan]
Hiroya Hayashi
Osaka Metropolitan University Graduate School of Medicine [Japan]
Hirono Satokawa
Fukushima Medical University, School of Medicine [Japan]
Yoshinori Okuno
Kyoto University Hospital [Japan]
Eriko Iwata
Nankai Medical Center Japan Community Health Care Organization [Japan]
Yoshito Ogihara
Mie University Hospital [Japan]
Nobutaka Ikeda
Toho University Ohashi Medical Center [Japan]
Akane Kondo
Shikoku Medical Center for Children and Adults [Japan]
Takehisa Iwai
Tsukuba Vascular Center [Japan]
Norikazu Yamada
Kuwana City Medical Center [Japan]
Tomohiro Ogawa
Fukushima Daiichi Hospital [Japan]
Takao Kobayashi
Hamamatsu Medical Center [Japan]
Makoto Mo
Yokohama Minami Kyosai Hospital [Japan]

Keywords: Anticoagulation, COVID-19, Critical illness, Severe illness, Thrombosis

JOURNAL OPEN ACCESS FULL-TEXT HTML Advance online publication

Article ID: CJ-22-0209

DOI https://doi.org/10.1253/circj.CJ-22-0209

The final version of this article is now available: Vol. 86 (2022), No. 7 pp. 1137-1142

Details

Abstract

Background: The potential benefit of therapeutic-dose anticoagulation for critically ill patients with coronavirus disease 2019 (COVID-19) is still controversial.

Methods and Results: In the CLOT-COVID study, 225 patients with severe COVID-19 on admission requiring mechanical ventilation or extracorporeal membrane oxygenation were divided into patients with therapeutic-dose anticoagulation (N=110) and those with prophylactic-dose anticoagulation (N=115). There was no significant difference in the incidence of thrombosis between the groups (9.1% vs. 7.8%, P=0.73).

Conclusions: Among a cohort of critically ill patients with COVID-19, approximately half received therapeutic-dose anticoagulation, although it did not show a potential benefit compared with prophylactic-dose anticoagulation.

Corresponding author

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