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Patients hospitalized with COVID-19 infection have excess risk for thromboembolic complications. In this meta-analysis of 22 randomized trials, researchers assessed clinical outcomes with various anticoagulation (AC) dosing strategies (i.e., prophylactic, intermediate, or therapeutic dosing) in ≈12,000 patients hospitalized with COVID-19 infections. Almost all studies were designed to assess various doses of low-molecular-weight heparins; only one study assessed therapeutic AC with an oral agent (rivaroxaban).
Compared with prophylactic AC, therapeutic AC significantly lowered 28-day mortality (7.9% vs. 9.8%; number needed to treat, 48) by preventing some thromboembolic events (2.3% vs. 4.8%; NNT, 40). However, mortality effect varied based …