Cochrane Corner: The use of anticoagulants in patients hospitalised with COVID-19

South Afr J Crit Care. 2023 Jul 28;39(2):10.7196/SAJCC.2023.v39i2.450. doi: 10.7196/SAJCC.2023.v39i2.450. eCollection 2023.

Abstract

Background: In this Cochrane Corner, we highlight the main findings of a Cochrane Review by Flumignan et al. entitled 'Anticoagulants for people hospitalised with COVID-19' and discuss the implications of these findings for research and practice in South Africa. In particular, we underscore the need for additional, high-quality, randomised controlled trials comparing different intensities of anticoagulation in patients with COVID-19 illness. Individuals in the intensive care unit and those hospitalised with another illness who are incidentally found to be infected with SARS-CoV-2 should still only be treated with prophylactic-dose low-molecular-weight heparin.

Contributions of the study: This Cochrane Corner summarises findings in a recent systematic review on the use of anticoagulation in people hospitalised with COVID-19, and provides insights on the implications of these findings for implementation by clinicians in South Africa. It highlights the need for clinicians to balance the benefits and harms of providing an anticoagulant, while considering the patients underlying risk for bleeding and thromboembolism.

Keywords: COVID-19; Cochrane Review; anticoagulants; bleeding; prophylactic-dose low-molecular-weight heparin; thromboembolism.