Therapeutic Anticoagulation with Heparin in Noncritically Ill Patients with Covid-19

This multicenter randomized trial assessed whether therapeutic-dose heparin improves outcomes in hospitalized noncritically ill Covid-19 patients. A total of 2219 participants across 9 countries were assigned either therapeutic-dose anticoagulation or usual-care thromboprophylaxis. The primary outcome organ support–free days, favored the therapeutic group (adjusted odds ratio 1.27; 95% credible interval: 1.03 to 1.58), with an adjusted absolute increase of 4.0 percentage points in survival without organ support. Benefits were consistent regardless of baseline D-dimer levels. Major bleeding occurred slightly more in the therapeutic group (1.9% vs. 0.9%). The study concludes that therapeutic heparin improves the likelihood of survival without organ support in moderately ill patients, though bleeding risks require consideration.

This multicenter randomized trial assessed whether therapeutic-dose heparin improves outcomes in hospitalized noncritically ill Covid-19 patients. A total of 2219 participants across 9 countries were assigned either therapeutic-dose anticoagulation or usual-care thromboprophylaxis. The primary outcome organ support–free days, favored the therapeutic group (adjusted odds ratio 1.27; 95% credible interval: 1.03 to 1.58), with an adjusted absolute increase of 4.0 percentage points in survival without organ support. Benefits were consistent regardless of baseline D-dimer levels. Major bleeding occurred slightly more in the therapeutic group (1.9% vs. 0.9%). The study concludes that therapeutic heparin improves the likelihood of survival without organ support in moderately ill patients, though bleeding risks require consideration.