@article{df08778965434c7fb95865b1efb15ec1,
title = "Anticoagulant interventions in hospitalized patients with COVID-19: A scoping review of randomized controlled trials and call for international collaboration",
abstract = "Introduction: Coronavirus disease (COVID-19) is associated with a high incidence of thrombosis and mortality despite standard anticoagulant thromboprophylaxis. There is equipoise regarding the optimal dose of anticoagulant intervention in hospitalized patients with COVID-19 and consequently, immediate answers from high-quality randomized trials are needed. Methods: The World Health Organization's International Clinical Trials Registry Platform was searched on June 17, 2020 for randomized controlled trials comparing increased dose to standard dose anticoagulant interventions in hospitalized COVID-19 patients. Two authors independently screened the full records for eligibility and extracted data in duplicate. Results: A total of 20 trials were included in the review. All trials are open label, 5 trials use an adaptive design, 1 trial uses a factorial design, 2 trials combine multi-arm parallel group and factorial designs in flexible platform trials, and at least 15 trials have multiple study sites. With individual target sample sizes ranging from 30 to 3000 participants, the pooled sample size of all included trials is 12 568 participants. Two trials include only intensive care unit patients, and 10 trials base patient eligibility on elevated D-dimer levels. Therapeutic intensity anticoagulation is evaluated in 14 trials. All-cause mortality is part of the primary outcome in 14 trials. Discussion: Several trials evaluate different dose regimens of anticoagulant interventions in hospitalized patients with COVID-19. Because these trials compete for sites and study participants, a collaborative effort is needed to complete trials faster, conduct pooled analyses and bring effective interventions to patients more quickly.",
keywords = "COVID-19, anticoagulant, pulmonary embolism, research networks, thrombosis",
author = "Tobias Tritschler and Marie-Eve Mathieu and Leslie Skeith and Marc Rodger and Saskia Middeldorp and Timothy Brighton and Sandset, {Per Morten} and Kahn, {Susan R} and Angus, {Derek C} and Marc Blondon and Bonten, {Marc J} and Marco Cattaneo and Mary Cushman and Derde, {Lennie P G} and DeSancho, {Maria T} and Jean-Luc Diehl and Ewan Goligher and Bernd Jilma and Peter J{\"u}ni and Lawler, {Patrick R} and Marco Marietta and Marshall, {John C} and Colin McArthur and Miranda, {Carlos Henrique} and Tristan Mirault and Nuccia Morici and Usha Perepu and Christian Sch{\"o}rgenhofer and Michelle Sholzberg and Spyropoulos, {Alex C} and Webb, {Steve A} and Ryan Zarychanski and St{\'e}phane Zuily and {Le Gal}, Gr{\'e}goire",
note = "Funding Information: TT, LS, MR, TB, PMS, and SK are members; SM is the chair; and GLG the vice‐chair of INVENT‐VTE. TT, LS, MS, RZ, GLG are members and MR and SK are the co‐directors of the Canadian Venous Thromboembolism Research Network (CanVECTOR), which receives grant funding from the Canadian Institutes of Health Research (Funding Reference: CDT‐142654). SM is the co‐chair of the Dutch Thrombosis Network. TB is a member of the Thrombosis and Haemostasis Society of Australasia and New Zealand (THANZ). PMS is a member of the Norwegian VECTOR Network. MM is a member of the Italian Society on Thrombosis and Haemostasis (SISET). TT is supported by a Fellowship Award from the CanVECTOR. MR is the McGill University Harry Webster Thorp Professor of Medicine. SK holds a Tier 1 Canada Research Chair in venous thromboembolism. PJ is a Tier 1 Canada Research Chair in Clinical Epidemiology of Chronic Diseases. GLG is supported by an Early Researcher Award from the Province of Ontario, a Mid‐Career Investigator Award from the Heart and Stroke Foundation of Ontario, and a Research Chair on the Diagnosis of Venous Thromboembolism, Department of Medicine, University of Ottawa. Funding Information: TT, LS, MR, TB, PMS, and SK are members; SM is the chair; and GLG the vice-chair of INVENT-VTE. TT, LS, MS, RZ, GLG are members and MR and SK are the co-directors of the Canadian Venous Thromboembolism Research Network (CanVECTOR), which receives grant funding from the Canadian Institutes of Health Research (Funding Reference: CDT-142654). SM is the co-chair of the Dutch Thrombosis Network. TB is a member of the Thrombosis and Haemostasis Society of Australasia and New Zealand (THANZ). PMS is a member of the Norwegian VECTOR Network. MM is a member of the Italian Society on Thrombosis and Haemostasis (SISET). TT is supported by a Fellowship Award from the CanVECTOR. MR is the McGill University Harry Webster Thorp Professor of Medicine. SK holds a Tier 1 Canada Research Chair in venous thromboembolism. PJ is a Tier 1 Canada Research Chair in Clinical Epidemiology of Chronic Diseases. GLG is supported by an Early Researcher Award from the Province of Ontario, a Mid-Career Investigator Award from the Heart and Stroke Foundation of Ontario, and a Research Chair on the Diagnosis of Venous Thromboembolism, Department of Medicine, University of Ottawa. Publisher Copyright: {\textcopyright} 2020 International Society on Thrombosis and Haemostasis",
year = "2020",
month = nov,
day = "1",
doi = "10.1111/jth.15094",
language = "English",
volume = "18",
pages = "2958--2967",
journal = "Journal of thrombosis and haemostasis : JTH",
issn = "1538-7933",
publisher = "Wiley-Blackwell",
number = "11",
}