Therapeutic versus prophylactic anticoagulation for patients admitted to hospital with COVID-19 and elevated D-dimer concentration (ACTION): an open-label, multicentre, randomised, controlled trial.
Renato D. Lopes,Pedro Gabriel Melo de Barros e Silva,Remo H.M. Furtado,Ariane Vieira Scarlatelli Macedo,Bruna Bronhara,Lucas P. Damiani,Lilian Mazza Barbosa,Júlia de Aveiro Morata,Eduardo Ramacciotti,Priscilla de Aquino Martins,Aryadne Lyrio de Oliveira,Vinicius Santana Nunes,Luiz Eduardo Fonteles Ritt,Ana Thereza Rocha,Lucas Tramujas,Sueli V Santos,Dario Rafael Abregu Diaz,Lorena Souza Viana,Livia Maria Garcia Melro,Mariana Silveira de Alcântara Chaud,Estêvão Lanna Figueiredo,Fernando Carvalho Neuenschwander,Marianna Deway Andrade Dracoulakis,Rodolfo Godinho Souza Dourado Lima,Vicente C.S. Dantas,Anne Cristine Silva Fernandes,Otavio Gebara,Mauro E. Hernandes,Diego Aparecido Rios Queiroz,Viviane C Veiga,Manoel Fernandes Canesin,Leonardo Meira de Faria,Gilson Soares Feitosa-Filho,Marcelo Basso Gazzana,Idelzuíta Leandro Liporace,Aline de Oliveira Twardowsky,Lilia Nigro Maia,Flávia Ribeiro Machado,Alexandre de Matos Soeiro,Germano Emílio Conceição-Souza,Luciana Armaganijan,Patrícia O. Guimarães,Regis Goulart Rosa,Luciano Cesar Pontes Azevedo,John H. Alexander,Alvaro Avezum,Alexandre Biasi Cavalcanti,Otavio Berwanger +47 more
TLDR
In this paper, the authors compared the efficacy and safety of therapeutic versus prophylactic anticoagulation in patients hospitalised with COVID-19 in 31 sites in Brazil, and found that in the case of stable patients, in-hospital oral rivaroxaban (20 mg or 15 mg daily) or initial subcutaneous enoxaparin (1 mg/kg twice per day) or intravenous unfractionated heparin (to achieve a 0·3-0·7 IU/mL anti-Xa concentration) for clinically unstable patients, followedAbout:
This article is published in The Lancet.The article was published on 2021-06-12 and is currently open access. It has received 326 citations till now. The article focuses on the topics: Rivaroxaban & Population.read more
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Efficacy and Safety of Therapeutic-Dose Heparin vs Standard Prophylactic or Intermediate-Dose Heparins for Thromboprophylaxis in High-risk Hospitalized Patients With COVID-19: The HEP-COVID Randomized Clinical Trial.
Alex C. Spyropoulos,Alex C. Spyropoulos,Alex C. Spyropoulos,Mark Goldin,Mark Goldin,Dimitrios Giannis,Wassim Diab,Janice Wang,Janice Wang,Sameer Khanijo,Andrea Mignatti,Andrea Mignatti,Eugenia Gianos,Eugenia Gianos,Marc Cohen,Gulru Sharifova,Jeet Lund,Alfonso Tafur,Alfonso Tafur,Paul A. Lewis,Kevin P. Cohoon,Husneara Rahman,Cristina Sison,Cristina Sison,Martin Lesser,Martin Lesser,Kanta Ochani,Nirav Agrawal,Judith Hsia,Victoria E. Anderson,Marc P. Bonaca,Jonathan L. Halperin,Jeffrey I. Weitz,Hep-Covid Investigators +33 more
TL;DR: In this article, the authors evaluated the effects of therapeutic-dose low-molecular-weight heparin (LMWH) vs institutional standard prophylactic or intermediate-dose heparins for thromboprophylaxis in high-risk hospitalized patients with COVID-19.
Journal ArticleDOI
Effectiveness of therapeutic heparin versus prophylactic heparin on death, mechanical ventilation, or intensive care unit admission in moderately ill patients with covid-19 admitted to hospital: RAPID randomised clinical trial.
Michelle Sholzberg,Grace H. Tang,Hassan Rahhal,Musaad AlHamzah,Lisa Baumann Kreuziger,Fionnuala Ní Áinle,Fionnuala Ní Áinle,Faris Alomran,Khalid Alayed,Mohammed AlSheef,Fahad AlSumait,Carlos Eduardo Pompilio,Catherine Sperlich,Sabrena Tangri,Terence Tang,Peter J. Jaksa,Deepa Suryanarayan,Mozah Obaid Almarshoodi,Lana A Castellucci,Paula D. James,David Lillicrap,Marc Carrier,Andrew Beckett,Christos Colovos,Christos Colovos,Jai Jayakar,Marie-Pier Arsenault,Cynthia Wu,Karine Doyon,E. Roseann Andreou,Vera Dounaevskaia,Eric Tseng,Gloria Lim,Michael Fralick,Saskia Middeldorp,Agnes Y.Y. Lee,Fei Zuo,Bruno R. da Costa,Bruno R. da Costa,Kevin E. Thorpe,Elnara Marcia Negri,Mary Cushman,Peter Jüni +42 more
TL;DR: In this paper, the authors evaluated the effects of therapeutic heparin compared with prophylactic hepharmin among moderately ill patients with covid-19 admitted to hospital wards.
Journal ArticleDOI
A guide to immunotherapy for COVID-19
Frank L. van de Veerdonk,Evangelos J. Giamarellos-Bourboulis,Peter Pickkers,Lennie P. G. Derde,Helen L. Leavis,Reinout van Crevel,Job J Engel,W. Joost Wiersinga,Alexander P.J. Vlaar,Manu Shankar-Hari,T. van der Poll,Marc J. M. Bonten,Derek C. Angus,Jos W. M. van der Meer,Mihai G. Netea +14 more
TL;DR: In this paper , the authors provide an overview of the evidence generated by major clinical trials of host-directed therapy for patients with COVID-19 and propose an algorithm to guide the use of immunotherapy strategies in the clinic.
Journal ArticleDOI
Long COVID: post-acute sequelae of COVID-19 with a cardiovascular focus
TL;DR: A possible model for referral of post-COVID-19 patients to cardiac services is proposed and future directions including research priorities and clinical trials that are currently underway to evaluate the efficacy of treatment strategies for long COVID and associated CV sequelae are discussed.
Journal ArticleDOI
Effect of Antithrombotic Therapy on Clinical Outcomes in Outpatients With Clinically Stable Symptomatic COVID-19: The ACTIV-4B Randomized Clinical Trial.
Jean M. Connors,Maria M. Brooks,Frank C. Sciurba,Jerry A. Krishnan,Joseph Bledsoe,Andrei L. Kindzelski,A. Baucom,Bridget-Anne Kirwan,Heather Eng,Deborah Martin,Elaine Zaharris,Brendan M. Everett,Lauren Castro,Nancy L. Shapiro,Janet Lin,Peter C. Hou,Carl J. Pepine,Eileen M. Handberg,Daniel O Haight,Jason W Wilson,Sarah Majercik,Zhuxuan Fu,Yongqi Zhong,Vidya Venugopal,Scott R. Beach,Steve Wisniewski,Paul M. Ridker +26 more
TL;DR: The ACTIV-4B Outpatient Thrombosis Prevention Trial as mentioned in this paper was designed as a minimal contact, adaptive, randomized, double-blind, placebo-controlled trial to compare anticoagulant and antiplatelet therapy among 7000 symptomatic but clinically stable outpatients with COVID-19.
References
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Rivaroxaban versus Warfarin in Nonvalvular Atrial Fibrillation
Manesh R. Patel,Kenneth W. Mahaffey,Jyotsna Garg,Guohua Pan,Daniel E. Singer,Werner Hacke,Günter Breithardt,Jonathan L. Halperin,Graeme J. Hankey,Jonathan P. Piccini,Richard C. Becker,Christopher C. Nessel,John F. Paolini,Scott D. Berkowitz,Robert M. Califf +14 more
TL;DR: In patients with atrial fibrillation, rivaroxaban was noninferior to warfarin for the prevention of stroke or systemic embolism and there was no significant between-group difference in the risk of major bleeding, although intracranial and fatal bleeding occurred less frequently in the rivroxaban group.
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Rivaroxaban with or without Aspirin in Stable Cardiovascular Disease
John W. Eikelboom,Stuart J. Connolly,Jackie Bosch,Gilles R. Dagenais,Robert G. Hart,Olga Shestakovska,Rafael Diaz,Marco Alings,Eva Lonn,Sonia S. Anand,Petr Widimsky,Masatsugu Hori,Alvaro Avezum,Leopoldo S. Piegas,Kelley R. Branch,Jeffrey L. Probstfield,Deepak L. Bhatt,Jun Zhu,Yan Liang,Aldo P. Maggioni,Patricio Lopez-Jaramillo,Martin O'Donnell,Ajay K. Kakkar,Keith A.A. Fox,Alexander Parkhomenko,Georg Ertl,Stefan Störk,Matyas Keltai,Lars Rydén,Nana Pogosova,Antonio L. Dans,Fernando Lanas,Patrick J. Commerford,Christian Torp-Pedersen,Tomek J. Guzik,Peter Verhamme,Dragos Vinereanu,Jae-Hyung Kim,Andrew Tonkin,Basil S. Lewis,Camilo Felix,Khalid Yusoff,P. Gabriel Steg,Kaj Metsärinne,Nancy Cook Bruns,Frank Misselwitz,Edmond Chen,Darryl P. Leong,Salim Yusuf +48 more
TL;DR: Among patients with stable atherosclerotic vascular disease, those assigned to rivaroxaban (2.5 mg twice daily) plus aspirin had better cardiovascular outcomes and more major bleeding events than those assign to aspirin alone.
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COVID-19 and coagulation: bleeding and thrombotic manifestations of SARS-CoV-2 infection.
Hanny Al-Samkari,Rebecca Karp Leaf,Walter H. Dzik,Jonathan C. T. Carlson,Annemarie E. Fogerty,Anem Waheed,Katayoon Goodarzi,Pavan K. Bendapudi,Larissa Bornikova,Shruti Gupta,Shruti Gupta,David E. Leaf,David E. Leaf,David J. Kuter,Rachel P. Rosovsky +14 more
TL;DR: Elevated D-dimer at initial presentation was predictive of coagulation-associated complications during hospitalization and ESR, CRP, fibrinogen, ferritin, and procalcitonin were higher in patients with thrombotic complications than in those without.
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