Titre :

Impact of High-Dose Prophylactic Anticoagulation in Critically Ill Patients With COVID-19 Pneumonia

Auteur(s) :

Tacquard, Charles [Auteur]
Centre Hospitalier Universitaire [Strasbourg] [CHU Strasbourg]
Mansour, Alexandre [Auteur]
Université de Rennes [UR]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
Godon, Alexandre [Auteur]
Centre Hospitalier Universitaire [CHU Grenoble] [CHUGA]
Godet, Julien [Auteur]
Centre Hospitalier Universitaire [Strasbourg] [CHU Strasbourg]
Poissy, Julien [Auteur]
425779|||Centre Hospitalier Régional Universitaire [Lille] [CHRU Lille]
Unité de Glycobiologie Structurale et Fonctionnelle (UGSF) - UMR 8576
Huet Garrigue, Delphine [Auteur]
425779|||Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille] (VALID)
Kipnis, Eric [Auteur]
Centre d'Infection et d'Immunité de Lille (CIIL) - U1019 - UMR 9017
Hamada, Sophie Rym [Auteur]
Hôpital Européen Georges Pompidou [APHP] [HEGP]
Mertes, Paul Michel [Auteur]
Centre Hospitalier Universitaire [Strasbourg] [CHU Strasbourg]
Steib, Annick [Auteur]
Centre Hospitalier Universitaire [Strasbourg] [CHU Strasbourg]
Ulliel-Roche, Mathilde [Auteur]
Centre Hospitalier Universitaire [CHU Grenoble] [CHUGA]
Bouhemad, Belaid [Auteur]
Lipides - Nutrition - Cancer [Dijon - U1231] [LNC]
Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand [CHU Dijon]
Nguyen, Maxime [Auteur]
Lipides - Nutrition - Cancer [Dijon - U1231] [LNC]
Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand [CHU Dijon]
Reizine, Florian [Auteur]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
Gouin-Thibault, Isabelle [Auteur]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
Besse, Marie Charlotte [Auteur]
CHU Trousseau [Tours]
Collercandy, Nived [Auteur]
CHU Trousseau [Tours]
Mankikian, Stefan [Auteur]
CHU Trousseau [Tours]
Levy, Jerrold H. [Auteur]
Duke University [Durham]
Gruel, Yves [Auteur]
CHU Trousseau [Tours]
Albaladejo, Pierre [Auteur]
Centre Hospitalier Universitaire [CHU Grenoble] [CHUGA]
Susen, Sophie [Auteur correspondant]
425779|||Centre Hospitalier Régional Universitaire [Lille] [CHRU Lille]
Godier, Anne [Auteur]
Hôpital Européen Georges Pompidou [APHP] [HEGP]

Titre de la revue :

Chest

Numéro :

159

Pagination :

2417-2427

Éditeur :

American College of Chest Physicians

Date de publication :

2021-06-01

ISSN :

0012-3692

Mot(s)-clé(s) en anglais :

anticoagulation
bleeding
COVID-19
thrombosis

Discipline(s) HAL :

Sciences du Vivant [q-bio]

Résumé en anglais : [en]

BACKGROUND: Because of the high risk of thrombotic complications (TCs) during SARS-CoV-2 infection, several scientific societies have proposed to increase the dose of preventive anticoagulation, although arguments in favor ...
Lire la suite >BACKGROUND: Because of the high risk of thrombotic complications (TCs) during SARS-CoV-2 infection, several scientific societies have proposed to increase the dose of preventive anticoagulation, although arguments in favor of this strategy are inconsistent. RESEARCH QUESTION: What is the incidence of TC in critically ill patients with COVID-19 and what is the relationship between the dose of anticoagulant therapy and the incidence of TC? STUDY DESIGN AND METHODS: All consecutive patients referred to eight French ICUs for COVID-19 were included in this observational study. Clinical and laboratory data were collected from ICU admission to day 14, including anticoagulation status and thrombotic and hemorrhagic events. The effect of high-dose prophylactic anticoagulation (either at intermediate or equivalent to therapeutic dose), defined using a standardized protocol of classification, was assessed using a time-varying exposure model using inverse probability of treatment weight. RESULTS: Of 538 patients included, 104 patients experienced a total of 122 TCs with an incidence of 22.7% (95% CI, 19.2%-26.3%). Pulmonary embolism accounted for 52% of the recorded TCs. High-dose prophylactic anticoagulation was associated with a significant reduced risk of TC (hazard ratio, 0.81; 95% CI, 0.66-0.99) without increasing the risk of bleeding (HR, 1.11; 95% CI, 0.70-1.75). INTERPRETATION: High-dose prophylactic anticoagulation is associated with a reduction in thrombotic complications in critically ill patients with COVID-19 without an increased risk of hemorrhage. Randomized controlled trials comparing prophylaxis with higher doses of anticoagulants are needed to confirm these results.Lire moins >

Langue :

Anglais

Comité de lecture :

Oui

Audience :

Internationale

Vulgarisation :

Non

Établissement(s) :

Université de Lille
CNRS

Collections :

• Centre d'Infection et d'Immunité de Lille (CIIL) - U1019 - UMR 9017
• Unité de Glycobiologie Structurale et Fonctionnelle (UGSF) - UMR 8576

Équipe(s) de recherche :

Glycobiology in fungal Pathogenesis and Clinical Applications

Date de dépôt :

2022-02-01T10:42:42Z
2022-03-08T08:03:05Z
2024-02-23T10:41:59Z