Supporting the Use of Therapeutic Heparin for Moderate COVID-19

Sumary of Supporting the Use of Therapeutic Heparin for Moderate COVID-19:

  • The study, published in the BMJ, was designed to evaluate whether therapeutic heparin is superior to prophylactic heparin for moderately ill patients with COVID-19 and increased D-dimer levels.
  • “Randomized trials suggest that therapeutic heparin is beneficial in moderately ill patients with COVID-19 admitted to hospital, but of no benefit and potential harm when provided to critically ill patients,” the study authors, led by Michelle Sholzberg, MDCM, assistant professor at the University of Toronto, wrote.
  • “The RAPID trial did not find a significant reduction in the primary composite outcome of death, mechanical ventilation, or ICU admission with therapeutic heparin,” the study authors wrote.
  • In conjunction with the recently published multi-platform trial, the RAPID trial therefore suggests that therapeutic heparin is beneficial in moderately ill patients with COVID-19 admitted to hospital wards.
  • Among limitations of the study, the authors noted that the trial was underpowered for the analysis of the primary outcome, which may explain the difference in significance of findings between the primary outcome and the secondary outcome of all-cause death.
  • Compared with other recent trials, the RAPID trial showed more pronounced mortality reduction.

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