@article{3020564,
    title = "Beneficial effects of intermediate dosage of anticoagulation treatment on the prognosis of hospitalized COVID-19 patients: The ETHRA study",
    author = "Poulakou, G. and Dimakakos, E. and Kollias, A. and Kyriakoulis, K.G. and Rapti, V. and Trontzas, I. and Thanos, C. and Abdelrasoul, M. and Vantana, T. and Leontis, K. and Kakalou, E. and Argyraki, K. and Baraboutis, I. and Michelakis, E. and Giamarellos-Bourboulis, E. and Dimakou, K. and Tsoukalas, G. and Rapti, A. and Michelakis, E.D. and Syrigos, K.N.",
    journal = "In vivo (Athens, Greece)",
    year = "2021",
    volume = "35",
    number = "1",
    pages = "653-661",
    publisher = "International Institute of Anticancer Research",
    doi = "10.21873/INVIVO.12305",
    keywords = "anticoagulant agent;  azithromycin;  D dimer;  enoxaparin;  ferritin;  fondaparinux;  hydroxychloroquine;  lopinavir plus ritonavir;  low molecular weight heparin;  oxygen;  remdesivir;  tinzaparin;  anticoagulant agent, adult;  anticoagulant therapy;  antiviral therapy;  Article;  atrial fibrillation;  bleeding;  clinical article;  computed tomographic angiography;  controlled study;  coronavirus disease 2019;  deep vein thrombosis;  drug safety;  drug withdrawal;  enzyme linked immunosorbent assay;  epistaxis;  female;  follow up;  glomerulus filtration rate;  Greece;  hemoptysis;  heparinization;  human;  limit of detection;  lung angiography;  lung embolism;  male;  medical record review;  middle aged;  oxygen saturation;  prognosis;  respiratory tract intubation;  retrospective study;  risk factor;  therapeutic dose;  thrombophilia;  thrombosis prevention;  venous thromboembolism;  aged;  blood;  blood clotting;  dose response;  drug effect;  hospital patient;  hospitalization;  isolation and purification;  physiology;  prevention and control;  treatment outcome;  venous thromboembolism;  very elderly;  virology, Adult;  Aged;  Aged, 80 and over;  Anticoagulants;  Blood Coagulation;  COVID-19;  Dose-Response Relationship, Drug;  Female;  Greece;  Hospitalization;  Humans;  Inpatients;  Male;  Middle Aged;  Retrospective Studies;  SARS-CoV-2;  Treatment Outcome;  Venous Thromboembolism",
    abstract = "Background/Aim: To investigate the efficacy (prognosis, coagulation/inflammation biomarkers) and safety (bleeding events) of different anticoagulation dosages in COVID-19 inpatients. Patients and Methods: COVID-19 inpatients (Athens, Greece) were included. The "Enhanced dose THRomboprophylaxis in Admissions (ETHRA)" protocol was applied in certain Departments, suggesting the use of intermediate anticoagulation dosage. The primary endpoint was a composite of intubation/venous thromboembolism/death. Inflammation/coagulation parameters were assessed. Results: Among 127 admissions, 95 fulfilled the inclusion criteria. Twenty-one events (4 deaths, 17 intubations) were observed. Regression analysis demonstrated significant reduction of events with intermediate or therapeutic dosage [HR=0.16 (95%CI=0.05-0.52) p=0.002; HR=0.17 (0.04-0.71) p=0.015, respectively]. D-Dimer values were higher in those who met the composite endpoint. Intermediate dosage treatment was associated with decreased values of ferritin. Three patients (3%) had minor hemorrhagic complications. Conclusion: Anticoagulation treatment (particularly intermediate dosage) appears to have positive impact on COVID-19 inpatients' prognosis by inhibiting both coagulation and inflammatory cascades. © 2021 International Institute of Anticancer Research. All rights reserved."
}