Please use this identifier to cite or link to this item:
Full metadata record
DC FieldValueLanguage
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.identifier.citationRESEARCH AND PRACTICE IN THROMBOSIS AND HAEMOSTASIS, v.5, n.8, article ID e12638, 9p, 2021-
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.relation.ispartofResearch and Practice in Thrombosis and Haemostasis-
dc.subjectclinical trialseng
dc.subject.otherprophylactic anticoagulationeng
dc.titleRandomized trials of therapeutic heparin for COVID-19: A meta-analysiseng
dc.rights.holderCopyright WILEYeng
dc.contributor.groupauthorRAPID Trial Investigators-
dc.subject.wosPeripheral Vascular Diseaseeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng, 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-, 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-, Grace H.:Univ Toronto, Hematol Oncol Clin Res Grp, St Michaels Hosp, Toronto, ON, Canada-, Musaad:King Saud Univ, Coll Med, Dept Surg, Riyadh, Saudi Arabia; King Saud Univ Med City, Div Vasc Surg, Riyadh, Saudi Arabia-, Lisa Baumann:Versiti, Med Coll Wisconsin, Milwaukee, WI USA-, Fionnuala Ni:Mater Misericordiae Univ Hosp, Dublin, Ireland; Univ Coll Dublin, Sch Med, Dublin, Ireland; Irish Network Venous Thromboembolism Res, Dublin, Ireland-, Mozah Obaid:Tawam Hosp, SEHA, Al Ain, U Arab Emirates-, Paula D.:Queens Univ, Dept Med, Kingston, ON, Canada-, David:Queens Univ, Dept Pathol & Mol Med, Kingston, ON, Canada-, Marc:Univ Ottawa, Ottawa Hosp Res Inst, Dept Med, Ottawa, ON, Canada-, Andrew:Univ Toronto, St Michaels Hosp, Toronto, ON, Canada; Canadian Forces Hlth Serv, Ottawa, ON, Canada-, Michael:Univ Toronto, Sinai Hlth, Gen Internal Med, Toronto, ON, Canada-, Saskia:Radboud Univ Nijmegen, Radboud Inst Hlth Sci RIHS, Dept Internal Med, Med Ctr, Nijmegen, Netherlands-, Agnes Y. Y.:Univ British Columbia, Vancouver Coastal Hlth Res Inst, Vancouver, BC, Canada-, Kevin E.:Univ Toronto, Appl Hlth Res Ctr, Dalla Lana Sch Publ Hlth, Li Ka Shing Knowledge Inst,St Michaels Hosp, Toronto, ON, Canada-, Mary:Univ Vermont, Dept Med, Med Ctr, Larner Coll Med, Burlington, VT USA-, 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.relation.referenceLemos ACB, 2020, THROMB RES, V196, P359, DOI 10.1016/j.thromres.2020.09.026eng
hcfmusp.relation.referenceBikdeli B, 2020, THROMB RES, V196, P638, DOI 10.1016/j.thromres.2020.09.033eng
hcfmusp.relation.referenceBuijsers B, 2020, EBIOMEDICINE, V59, DOI 10.1016/j.ebiom.2020.102969eng
hcfmusp.relation.referenceClausen TM, 2020, CELL, V183, P1043, DOI [10.1016/j.cell.2020.09.033, 10.1101/2020.07.14.201616]eng
hcfmusp.relation.referenceda Costa BR, 2014, EUR HEART J, V35, P3336, DOI 10.1093/eurheartj/ehu424eng
hcfmusp.relation.referenceGoldin M, 2021, THROMB HAEMOSTASIS, V121, P1684, DOI 10.1055/a-1475-2351eng
hcfmusp.relation.referenceGordon AC, 2021, NEW ENGL J MED, V384, P1491, DOI 10.1056/NEJMoa2100433eng
hcfmusp.relation.referenceHouston BL, 2020, CLIN TRIALS, V17, P491, DOI 10.1177/1740774520943846eng
hcfmusp.relation.referenceIba T, 2020, CRIT CARE MED, V48, P1358, DOI 10.1097/CCM.0000000000004458eng
hcfmusp.relation.referenceLawler PR, 2021, NEW ENGL J MED, V385, P790, DOI 10.1056/NEJMoa2105911eng
hcfmusp.relation.referenceLopes RD, 2021, LANCET, V397, P2253, DOI 10.1016/S0140-6736(21)01203-4eng
hcfmusp.relation.referenceMcGonagle D, 2020, LANCET RHEUMATOL, V2, pE437, DOI 10.1016/S2665-9913(20)30121-1eng
hcfmusp.relation.referenceMycroft-West CJ, 2020, THROMB HAEMOSTASIS, V120, P1700, DOI 10.1055/s-0040-1721319eng
hcfmusp.relation.referenceNopp S, 2020, RES PRACT THROMB HAE, V4, P1178, DOI 10.1002/rth2.12439eng
hcfmusp.relation.referenceOrtega-Paz L., 2021, EUR HEART J-CARD IMGeng
hcfmusp.relation.referencePage Clive, 2013, ISRN Pharmacol, V2013, P910743, DOI 10.1155/2013/910743eng
hcfmusp.relation.referencePage MJ, 2021, PLOS MED, V18, DOI [10.1016/j.ijsu.2021.105906, 10.1371/journal.pmed.1003583]eng
hcfmusp.relation.referenceParanjpe I, 2020, J AM COLL CARDIOL, V76, P122, DOI 10.1016/j.jacc.2020.05.001eng
hcfmusp.relation.referencePerepu US, 2021, J THROMB HAEMOST, V19, P2225, DOI 10.1111/jth.15450eng
hcfmusp.relation.referencePoor HD, 2021, CHEST, V160, P1471, DOI 10.1016/j.chest.2021.06.016eng
hcfmusp.relation.referenceSadeghipour P, 2021, JAMA-J AM MED ASSOC, V325, P1620, DOI 10.1001/jama.2021.4152eng
hcfmusp.relation.referenceSchulman S, 2005, J THROMB HAEMOST, V3, P692, DOI 10.1111/j.1538-7836.2005.01204.xeng
hcfmusp.relation.referenceSholzberg M, 2021, BMJ-BRIT MED J, V375, DOI 10.1136/bmj.n2400eng
hcfmusp.relation.referenceSholzberg M, 2021, TRIALS, V22, DOI 10.1186/s13063-021-05076-0eng
hcfmusp.relation.referenceSpyropoulos AC, 2021, JAMA INTERN MED, V181, P1612, DOI 10.1001/jamainternmed.2021.6203eng
hcfmusp.relation.referenceSterne JAC, 2019, BMJ-BRIT MED J, V366, DOI 10.1136/bmj.l4898eng
hcfmusp.relation.referenceTang N, 2020, J THROMB HAEMOST, V18, P1094, DOI 10.1111/jth.14817eng
hcfmusp.relation.referenceten Cate H, 2021, NEW ENGL J MED, V385, P845, DOI 10.1056/NEJMe2111151eng
hcfmusp.relation.referenceTritschler T, 2020, J THROMB HAEMOST, V18, P2958, DOI 10.1111/jth.15094eng
hcfmusp.relation.referenceWHO Solidarity Trial Consortium, 2021, NEW ENGL J MED, V384, P497, DOI 10.1056/NEJMoa2023184eng
hcfmusp.relation.referenceZhou F, 2020, LANCET, V395, P1054, DOI 10.1016/S0140-6736(20)30566-3eng
Appears in Collections:

Artigos e Materiais de Revistas Científicas - 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

Files in This Item:
File Description SizeFormat 
art_SHOLZBERG_Randomized_trials_of_therapeutic_heparin_for_COVID19_A_2021.PDFpublishedVersion (English)1.51 MBAdobe PDFThumbnail

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.