Full-dose anticoagulation lowers the risk of blood clotting complications in COVID-19 patients

A clinical trial of patients with COVID-19 led by investigators at the TIMI Study Group at Brigham and Women's Hospital and the Critical Care Cardiology Trials Network (CCCTN) has found that full-dose anticoagulation lowers the risk of blood clotting complications compared with standard-dose prophylactic anticoagulation. Investigators presented their findings at a Hot Line session at ESC Congress 2022. Results from previous clinical trials assessing strategies for preventing blood clots in patients with COVID-19 have been mixed. The COVID-PACT trial enrolled critically ill patients with COVID-19 from sites across the U.S. Patients were randomized to receive either full-dose or standard-dose prophylactic anticoagulation therapy. A total of 390 patients were randomized to an anticoagulation strategy. Investigators found that the risk of venous or arterial clotting complications was 44 percent lower among patients who received full-dose compared to standard-dose. Fatal or life-threatening bleeding occurred in four patients in the full-dose group compared to one patient in the standard-dose group.

Until now, the optimal strategy for preventing blood clots among patients who are critically ill with COVID-19 has remained uncertain. COVID-PACT shows that, compared with standard-dose prophylaxis, full-dose anticoagulation more effectively prevents the clotting complications of COVID-19."

David Berg, MD, MPH, Division of Cardiovascular Medicine