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1. Beneficial effects of intermediate dosage of anticoagulation treatment on the prognosis of hospitalized COVID-19 patients: The ETHRA study

Author

Poulakou, G. Dimakakos, E. Kollias, A. Kyriakoulis, K.G. Rapti, V. Trontzas, I. Thanos, C. Abdelrasoul, M. Vantana, T. Leontis, K. Kakalou, E. Argyraki, K. Baraboutis, I. Michelakis, E. Giamarellos-Bourboulis, E. Dimakou, K. Tsoukalas, G. Rapti, A. Michelakis, E.D. Syrigos, K.N.

Abstract

Background/Aim: To investigate the efficacy (prognosis, coagulation/inflammation biomarkers) and safety (bleeding events) of different anticoagulation dosages in COVID-19 inpatients. Patients and Methods: COVID-19 inpatients (Athens, Greece) were included. The "Enhanced dose THRomboprophylaxis in Admissions (ETHRA)" protocol was applied in certain Departments, suggesting the use of intermediate anticoagulation dosage. The primary endpoint was a composite of intubation/venous thromboembolism/death. Inflammation/coagulation parameters were assessed. Results: Among 127 admissions, 95 fulfilled the inclusion criteria. Twenty-one events (4 deaths, 17 intubations) were observed. Regression analysis demonstrated significant reduction of events with intermediate or therapeutic dosage [HR=0.16 (95%CI=0.05-0.52) p=0.002; HR=0.17 (0.04-0.71) p=0.015, respectively]. D-Dimer values were higher in those who met the composite endpoint. Intermediate dosage treatment was associated with decreased values of ferritin. Three patients (3%) had minor hemorrhagic complications. Conclusion: Anticoagulation treatment (particularly intermediate dosage) appears to have positive impact on COVID-19 inpatients' prognosis by inhibiting both coagulation and inflammatory cascades. © 2021 International Institute of Anticancer Research. All rights reserved.

Published
2021

2. Beneficial Effects of Intermediate Dosage of Anticoagulation Treatment on the Prognosis of Hospitalized COVID-19 Patients: The ETHRA Study.

Author

Poulakou G, Dimakakos E, Kollias A, Kyriakoulis KG, Rapti V, Trontzas I, Thanos C, Abdelrasoul M, Vantana T, Leontis K, Kakalou E, Argyraki K, Baraboutis I, Michelakis E, Giamarellos-Bourboulis E, Dimakou K, Tsoukalas G, Rapti A, Michelakis ED, and Syrigos KN

Subjects
Adult, Aged, Aged, 80 and over, Anticoagulants administration & dosage, COVID-19 blood, COVID-19 virology, Dose-Response Relationship, Drug, Female, Greece, Humans, Inpatients statistics & numerical data, Male, Middle Aged, Retrospective Studies, SARS-CoV-2 physiology, Treatment Outcome, Venous Thromboembolism blood, Anticoagulants therapeutic use, Blood Coagulation drug effects, COVID-19 prevention & control, Hospitalization statistics & numerical data, SARS-CoV-2 isolation & purification, Venous Thromboembolism drug therapy
Abstract

Background/aim: To investigate the efficacy (prognosis, coagulation/inflammation biomarkers) and safety (bleeding events) of different anticoagulation dosages in COVID-19 inpatients., Patients and Methods: COVID-19 inpatients (Athens, Greece) were included. The "Enhanced dose THRomboprophylaxis in Admissions (ETHRA)" protocol was applied in certain Departments, suggesting the use of intermediate anticoagulation dosage. The primary endpoint was a composite of intubation/venous thromboembolism/death. Inflammation/coagulation parameters were assessed., Results: Among 127 admissions, 95 fulfilled the inclusion criteria. Twenty-one events (4 deaths, 17 intubations) were observed. Regression analysis demonstrated significant reduction of events with intermediate or therapeutic dosage [HR=0.16 (95%CI=0.05-0.52) p=0.002; HR=0.17 (0.04-0.71) p=0.015, respectively]. D-Dimer values were higher in those who met the composite endpoint. Intermediate dosage treatment was associated with decreased values of ferritin. Three patients (3%) had minor hemorrhagic complications., Conclusion: Anticoagulation treatment (particularly intermediate dosage) appears to have positive impact on COVID-19 inpatients' prognosis by inhibiting both coagulation and inflammatory cascades., (Copyright© 2021, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Published
2021
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