@article{5c1a0b0c442d48328f013916e3ea7d5c,
title = "Anticoagulation in Patients With COVID-19: JACC Review Topic of the Week",
abstract = "Clinical, laboratory, and autopsy findings support an association between coronavirus disease-2019 (COVID-19) and thromboembolic disease. Acute COVID-19 infection is characterized by mononuclear cell reactivity and pan-endothelialitis, contributing to a high incidence of thrombosis in large and small blood vessels, both arterial and venous. Observational studies and randomized trials have investigated whether full-dose anticoagulation may improve outcomes compared with prophylactic dose heparin. Although no benefit for therapeutic heparin has been found in patients who are critically ill hospitalized with COVID-19, some studies support a possible role for therapeutic anticoagulation in patients not yet requiring intensive care unit support. We summarize the pathology, rationale, and current evidence for use of anticoagulation in patients with COVID-19 and describe the main design elements of the ongoing FREEDOM COVID-19 Anticoagulation trial, in which 3,600 hospitalized patients with COVID-19 not requiring intensive care unit level of care are being randomized to prophylactic-dose enoxaparin vs therapeutic-dose enoxaparin vs therapeutic-dose apixaban.",
keywords = "COVID-19, anticoagulation, clinical trial, coagulopathy",
author = "Farkouh, {Michael E.} and Stone, {Gregg W.} and Anuradha Lala and Emilia Bagiella and Moreno, {Pedro R.} and Nadkarni, {Girish N.} and Ori Ben-Yehuda and Granada, {Juan F.} and Ovidiu Dressler and Tinuoye, {Elizabeth O.} and Carlos Granada and Jessica Bustamante and Carlos Peyra and Godoy, {Lucas C.} and Palacios, {Igor F.} and Valentin Fuster",
note = "Funding Information: Dr Farkouh has received research grants from Amgen, Novo Nordisk, and Novartis. Dr Stone has received speaker honoraria from Infraredx; has served as a consultant to Valfix, TherOx, Robocath, HeartFlow, Ablative Solutions, Miracor, Neovasc, Abiomed, Ancora, Vectorious, Elucid Bio, Occlutech, CorFlow, Apollo Therapeutics, Impulse Dynamics, Cardiomech, Gore, and Amgen; and has equity/options from Ancora, Cagent, Applied Therapeutics, Biostar family of funds, SpectraWave, Orchestra Biomed, Aria, Cardiac Success, Valfix, and Xenter. Dr Godoy is supported by the Frederick Banting and Charles Best Canada Graduate Scholarship (Doctoral Research Award) from the Canadian Institutes of Health Research. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. Publisher Copyright: {\textcopyright} 2022 The Authors",
year = "2022",
month = mar,
day = "8",
doi = "10.1016/j.jacc.2021.12.023",
language = "English",
volume = "79",
pages = "917--928",
journal = "Journal of the American College of Cardiology",
issn = "0735-1097",
publisher = "Elsevier USA",
number = "9",
}