Please use this identifier to cite or link to this item: https://observatorio.fm.usp.br/handle/OPI/46178
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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP-
dc.contributor.authorSHOLZBERG, Michelle-
dc.contributor.authorCOSTA, Bruno R. da-
dc.contributor.authorTANG, Grace H.-
dc.contributor.authorRAHHAL, Hassan-
dc.contributor.authorALHAMZAH, Musaad-
dc.contributor.authorKREUZIGER, Lisa Baumann-
dc.contributor.authorAINLE, Fionnuala Ni-
dc.contributor.authorALMARSHOODI, Mozah Obaid-
dc.contributor.authorJAMES, Paula D.-
dc.contributor.authorLILLICRAP, David-
dc.contributor.authorCARRIER, Marc-
dc.contributor.authorBECKETT, Andrew-
dc.contributor.authorFRALICK, Michael-
dc.contributor.authorMIDDELDORP, Saskia-
dc.contributor.authorLEE, Agnes Y. Y.-
dc.contributor.authorTHORPE, Kevin E.-
dc.contributor.authorNEGRI, Elnara Marcia-
dc.contributor.authorCUSHMAN, Mary-
dc.contributor.authorJUNI, Peter-
dc.date.accessioned2022-04-19T13:07:02Z-
dc.date.available2022-04-19T13:07:02Z-
dc.date.issued2021-
dc.identifier.citationRESEARCH AND PRACTICE IN THROMBOSIS AND HAEMOSTASIS, v.5, n.8, article ID e12638, 9p, 2021-
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/46178-
dc.description.abstractBackground: Pulmonary endothelial injury and microcirculatory thromboses likely contribute to hypoxemic respiratory failure, the most common cause of death, in patients with COVID-19. Randomized controlled trials (RCTs) suggest differences in the effect of therapeutic heparin between moderately and severely ill patients with COVID-19. We did a systematic review and meta-analysis of RCTs to determine the effects of therapeutic heparin in hospitalized patients with COVID-19. Methods: We searched PubMed, Embase, Web of Science, medRxiv, and medical conference proceedings for RCTs comparing therapeutic heparin with usual care, excluding trials that used oral anticoagulation or intermediate doses of heparin in the experimental arm, Mantel-Haenszel fixed-effect meta-analysis was used to combine odds ratios (ORs). Results and Conclusions: There were 3 RCTs that compared therapeutic heparin to lower doses of heparin in 2854 moderately ill ward patients, and 3 RCTs in 1191 severely ill patients receiving critical care. In moderately ill patients, there was a nonsignificant reduction in all-cause death (OR, 0.76; 95% CI, 0.57-1.02), but significant reductions in the composite of death or invasive mechanical ventilation (OR, 0.77; 95% CI, 0.60 0.98), and death or any thrombotic event (OR, 0.58; 95% CI, 0.45-0.77). Organ support-free days alive (OR, 1.29; 95% CI, 1.07-1.57) were significantly increased with therapeutic heparin. There was a nonsignificant increase in major bleeding. In severely ill patients, there was no evidence for benefit of therapeutic heparin, with significant treatment-by-subgroup interactions with illness severity for all-cause death (P = .034). In conclusion, therapeutic heparin is beneficial in moderately ill patients but not in severely ill patients hospitalized with COVID-19.eng
dc.description.sponsorshipDefense Research Development Canada, Department of National Defense, Ottawa, Canada-
dc.language.isoeng-
dc.publisherWILEYeng
dc.relation.ispartofResearch and Practice in Thrombosis and Haemostasis-
dc.rightsopenAccesseng
dc.subjectanticoagulationeng
dc.subjectclinical trialseng
dc.subjectCOVID-19eng
dc.subjectheparineng
dc.subjectmeta-analysiseng
dc.subject.otherprophylactic anticoagulationeng
dc.titleRandomized trials of therapeutic heparin for COVID-19: A meta-analysiseng
dc.typearticleeng
dc.rights.holderCopyright WILEYeng
dc.contributor.groupauthorRAPID Trial Investigators-
dc.identifier.doi10.1002/rth2.12638-
dc.identifier.pmid34977448-
dc.subject.wosHematologyeng
dc.subject.wosPeripheral Vascular Diseaseeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
hcfmusp.author.externalSHOLZBERG, Michelle:Univ Toronto, Li Ka Shing Knowledge Inst, St Michaels Hosp, Dept Med, Toronto, ON, Canada; Univ Toronto, Li Ka Shing Knowledge Inst, Dept Lab Med & Pathobiol, St Michaels Hosp, Toronto, ON, Canada-
hcfmusp.author.externalCOSTA, Bruno R. da:Univ Toronto, Appl Hlth Res Ctr AHRC, Li Ka Shing Knowledge Inst, St Michaels Hosp, Toronto, ON, Canada; Univ Bern, Inst Primary Hlth Care BIHAM, Bern, Switzerland-
hcfmusp.author.externalTANG, Grace H.:Univ Toronto, Hematol Oncol Clin Res Grp, St Michaels Hosp, Toronto, ON, Canada-
hcfmusp.author.externalALHAMZAH, Musaad:King Saud Univ, Coll Med, Dept Surg, Riyadh, Saudi Arabia; King Saud Univ Med City, Div Vasc Surg, Riyadh, Saudi Arabia-
hcfmusp.author.externalKREUZIGER, Lisa Baumann:Versiti, Med Coll Wisconsin, Milwaukee, WI USA-
hcfmusp.author.externalAINLE, Fionnuala Ni:Mater Misericordiae Univ Hosp, Dublin, Ireland; Univ Coll Dublin, Sch Med, Dublin, Ireland; Irish Network Venous Thromboembolism Res, Dublin, Ireland-
hcfmusp.author.externalALMARSHOODI, Mozah Obaid:Tawam Hosp, SEHA, Al Ain, U Arab Emirates-
hcfmusp.author.externalJAMES, Paula D.:Queens Univ, Dept Med, Kingston, ON, Canada-
hcfmusp.author.externalLILLICRAP, David:Queens Univ, Dept Pathol & Mol Med, Kingston, ON, Canada-
hcfmusp.author.externalCARRIER, Marc:Univ Ottawa, Ottawa Hosp Res Inst, Dept Med, Ottawa, ON, Canada-
hcfmusp.author.externalBECKETT, Andrew:Univ Toronto, St Michaels Hosp, Toronto, ON, Canada; Canadian Forces Hlth Serv, Ottawa, ON, Canada-
hcfmusp.author.externalFRALICK, Michael:Univ Toronto, Sinai Hlth, Gen Internal Med, Toronto, ON, Canada-
hcfmusp.author.externalMIDDELDORP, Saskia:Radboud Univ Nijmegen, Radboud Inst Hlth Sci RIHS, Dept Internal Med, Med Ctr, Nijmegen, Netherlands-
hcfmusp.author.externalLEE, Agnes Y. Y.:Univ British Columbia, Vancouver Coastal Hlth Res Inst, Vancouver, BC, Canada-
hcfmusp.author.externalTHORPE, Kevin E.:Univ Toronto, Appl Hlth Res Ctr, Dalla Lana Sch Publ Hlth, Li Ka Shing Knowledge Inst,St Michaels Hosp, Toronto, ON, Canada-
hcfmusp.author.externalCUSHMAN, Mary:Univ Vermont, Dept Med, Med Ctr, Larner Coll Med, Burlington, VT USA-
hcfmusp.author.externalJUNI, Peter:Univ Toronto, Appl Hlth Res Ctr, Li Ka Shing Knowledge Inst, Dept Med,St Michaels Hosp,Inst Hlth Policy Manage, Toronto, ON, Canada-
hcfmusp.description.articlenumbere12638-
hcfmusp.description.issue8-
hcfmusp.description.volume5-
hcfmusp.origemWOS-
hcfmusp.origem.idWOS:000756485300014-
hcfmusp.origem.id2-s2.0-85122084631-
hcfmusp.publisher.cityHOBOKENeng
hcfmusp.publisher.countryUSAeng
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dc.description.indexPubMedeng
dc.identifier.eissn2475-0379-
hcfmusp.citation.scopus8-
hcfmusp.scopus.lastupdate2022-08-11-
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Artigos e Materiais de Revistas Científicas - COVID-19
COVID-19

Artigos e Materiais de Revistas Científicas - HC/ICHC
Instituto Central - HC/ICHC

Artigos e Materiais de Revistas Científicas - LIM/59
LIM/59 - Laboratório de Biologia Celular


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