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

This international multiplatform randomized trial investigated whether therapeutic-dose heparin improves outcomes in critically ill patients with Covid-19. A total of 1098 patients were randomized to either therapeutic-dose anticoagulation or standard pharmacologic thromboprophylaxis. The trial was halted after meeting futility criteria. Organ support–free days (a measure combining mortality and days free of cardiovascular or respiratory support) were lower in the therapeutic group, with no survival benefit observed. Major bleeding rates were slightly higher with therapeutic anticoagulation (3.8% vs. 2.3%). The findings indicate that therapeutic-dose heparin does not enhance survival or reduce organ support needs compared to standard care in ICU-level Covid-19 cases.

This international multiplatform randomized trial investigated whether therapeutic-dose heparin improves outcomes in critically ill patients with Covid-19. A total of 1098 patients were randomized to either therapeutic-dose anticoagulation or standard pharmacologic thromboprophylaxis. The trial was halted after meeting futility criteria. Organ support–free days (a measure combining mortality and days free of cardiovascular or respiratory support) were lower in the therapeutic group, with no survival benefit observed. Major bleeding rates were slightly higher with therapeutic anticoagulation (3.8% vs. 2.3%). The findings indicate that therapeutic-dose heparin does not enhance survival or reduce organ support needs compared to standard care in ICU-level Covid-19 cases.