Evidence map›Paper›PMID 32220112›Full record

ArticleJournal of thrombosis and haemostasis : JTH2020

Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy.

Ning Tang, Huan Bai, Xing Chen, Jiale Gong, Dengju Li, Ziyong Sun

10 registry-linked trialsOpen access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of thrombosis and haemostasis : JTH, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 10 registered trials, which are not on this map. Cited by 2,069 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2,069citing papers in PubMed, 10 pooled it
90.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04377997 phase2unknown statusnot on this map

A Randomized, Open-Label Trial of Therapeutic Anticoagulation in COVID-19 Patients With an Elevated D-Dimer

TypeinterventionalSponsorMassachusetts General HospitalRan2020 to 2022Enrolled300ConditionsCardiovascular Diseases, COVID-19ArmsEnoxaparin
NCT04406389 phase4terminatednot on this map

InterMediate ProphylACtic Versus Therapeutic Dose Anticoagulation in Critically Ill Patients With COVID-19: A Prospective Randomized Study (The IMPACT Trial)

TypeinterventionalSponsorWeill Medical College of Cornell UniversityRan2020 to 2022Enrolled14ConditionsCOVID-19ArmsEnoxaparin sodium, Unfractionated heparin, Fondapariniux, Argatroban
NCT04408235 phase3unknown statusnot on this map

Randomised Controlled Trial Comparing High Versus Low LMWH Dosages in Hospitalized Patients With Severe COVID-19 Pneumonia and Coagulopathy Not Requiring Invasive Mechanical Ventilation

TypeinterventionalSponsorAzienda Ospedaliero-Universitaria di ModenaRan2020 to 2021Enrolled300ConditionsCOVID, Pneumonia, Viral, Coagulation DisorderArmsEnoxaparin
NCT04420312 completednot on this map

Incidence and Characteristics of Pulmonary Embolism in COVID-19 Patients Hospitalized for Acute Respiratory Syndrome

TypeobservationalSponsorFondation Hôpital Saint-JosephRan2020 to 2020Enrolled1,024ConditionsPulmonary Embolism, Covid-19
NCT04492254 phase3terminatednot on this map

Early Thromboprophylaxis in COVID-19 (ETHIC Trial): an Open Label, Randomized Phase IIIb Trial of Community-based (LMWH) Versus Standard of Care (no Enoxaparin) in COVID-19 Positive Patients

TypeinterventionalSponsorThrombosis Research InstituteRan2020 to 2021Enrolled219ConditionsCOVID-19ArmsEnoxaparin
NCT04505774 phase4completednot on this map

A Multicenter, Adaptive, Randomized Controlled Platform Trial of the Safety and Efficacy of Antithrombotic and Additional Strategies in Hospitalized Adults With COVID-19

TypeinterventionalSponsorMatthew Neal MDRan2020 to 2024Enrolled3,591ConditionsCovid19Armstheraputic heparin, prophylactic heparin, P2Y12, Crizanlizumab Injection, SGLT2 inhibitor
NCT04530578 phase4unknown statusnot on this map

Efficacy and Safety Study to Evaluate the Use of Nebulized Heparin in Patients With Severe Acute Respiratory Syndrome Covid-19 (SARS-CoV-2)

TypeinterventionalSponsorClinica San Camilo, ArgentinaRan2020 to 2021Enrolled200ConditionsCovid19, PneumoniaArmsHeparin sodium, Enoxaparin
NCT04558125 phase4terminatednot on this map

Low-Dose Tenecteplase in Covid-19 Patients With Acute Pulmonary Embolism: A Randomized, Double-Blind, Placebo-Controlled Trial

TypeinterventionalSponsorCedars-Sinai Medical CenterRan2020 to 2021Enrolled2ConditionsPulmonary Embolism, COVIDArmsTNKase, Placebo, Enoxaparin
NCT04623177 completednot on this map

Effectiveness of Thromboprophylaxis With Low Molecular Weight Heparin in Critically Ill Patients With COVID-19. A Prospective, Cohort, Multicenter Study.

TypeobservationalSponsorInstituto de Investigacion Sanitaria La FeRan2020 to 2020Enrolled822ConditionsCovid19, Anticoagulant Therapy, Thrombosis
NCT04646655 phase3completednot on this map

Enoxaparin at Prophylactic or Therapeutic Doses With Monitoring of Outcomes in Subjects Infected With COVID-19: a Pilot Study on 300 Cases Enrolled at ASST-FBF-Sacco

TypeinterventionalSponsorASST Fatebenefratelli SaccoRan2020 to 2023Enrolled142ConditionsCovid19, ThrombosisArmsEnoxaparin
3 · Its place in the literature

Who cites it

2,069 citing papers in PubMed, 10 syntheses or guidelines pooled it, 3,729 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Guideline
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Pooled it
  9. Pooled it
  10. Pooled it
  11. Trial
  12. Trial
  13. Article
  14. Admission biomarkers and COVID-19 mortality: A retrospective study during Vietnam's pandemic peak.Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2026
    Article
  15. Review
  16. Article
  17. Article
  18. Article
  19. Article
  20. Review

2,009 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Ning TangDepartment of Clinical Laboratory, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Huan BaiDepartment of Clinical Laboratory, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Xing ChenDepartment of Clinical Laboratory, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Jiale GongDepartment of Clinical Laboratory, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Dengju LiDepartment of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Ziyong SunDepartment of Clinical Laboratory, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Tongji Hospital · CN

Funding

National Mega Project on Major Infectious Disease Prevention of China 2017ZX10103005-007
6 · The paper itself

Abstract

backgroundA relatively high mortality of severe coronavirus disease 2019 (COVID-19) is worrying, and the application of heparin in COVID-19 has been recommended by some expert consensus because of the risk of disseminated intravascular coagulation and venous thromboembolism. However, its efficacy remains to be validated.

methodsCoagulation results, medications, and outcomes of consecutive patients being classified as having severe COVID-19 in Tongji hospital were retrospectively analyzed. The 28-day mortality between heparin users and nonusers were compared, as was a different risk of coagulopathy, which was stratified by the sepsis-induced coagulopathy (SIC) score or D-dimer result.

resultsThere were 449 patients with severe COVID-19 enrolled into the study, 99 of them received heparin (mainly with low molecular weight heparin) for 7 days or longer. D-dimer, prothrombin time, and age were positively, and platelet count was negatively, correlated with 28-day mortality in multivariate analysis. No difference in 28-day mortality was found between heparin users and nonusers (30.3% vs 29.7%, P = .910). But the 28-day mortality of heparin users was lower than nonusers in patients with SIC score ≥4 (40.0% vs 64.2%, P = .029), or D-dimer >6-fold of upper limit of normal (32.8% vs 52.4%, P = .017).

conclusionsAnticoagulant therapy mainly with low molecular weight heparin appears to be associated with better prognosis in severe COVID-19 patients meeting SIC criteria or with markedly elevated D-dimer.

Indexed as

BetacoronavirusCoronavirus InfectionsDisseminated Intravascular CoagulationPandemicsPneumonia, ViralAgedAge FactorsAnticoagulantsBiomarkersBlood Coagulation TestsCOVID-19FemaleFibrin Fibrinogen Degradation ProductsHeparin, Low-Molecular-WeightHumansMaleAnticoagulantsBiomarkersFibrin Fibrinogen Degradation Productsfibrin fragment DHeparin, Low-Molecular-Weightcoagulopathycoronavirus disease 2019D-dimerlow molecular weight heparinsepsis

Identifiers

PMID32220112
PMCPMC9906401
OpenAlexW3013486442

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

and 4 more above

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.