Living meta-analysis and evidence synthesis of therapies for COVID-19

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REMAP-CAP, ACTIV-4a, ATTACC (critically ill patients), 2021 NCT02735707

anticoagulant, curative dose (n=591) vs. anticoagulant, prophylactic dose (n=616)

randomized controlled trial   some concerns about risk of bias

Studied treatment

therapeutic anticoagulation with heparin
Therapeutic anticoagulation was administered according to local site protocols for the treatment of acute venous thromboembolism for up to 14 days or recovery

Control treatment

pharmacological thromboprophylaxis as per local usual care

Patients

COVID-19 severe or critically

Method

open-blind

Remark

NCT02735707, NCT04505774, NCT04359277, NCT04372589

COVID-PACT, 2022

anticoagulant, curative dose (n=191) vs. anticoagulant, prophylactic dose (n=191)

randomized controlled trial   some concerns about risk of bias

Studied treatment

full-dose anticoagulation

Control treatment

standard-dose prophylactic anticoagulation

Patients

COVID-19 severe or critically

Method

open label

34 centers, United States

2x2 factorial deisgn with clopidogrel or no antiplatelet therapy; recruitment was stopped early in 03/2022 (∼50% planned recruitment) due to waning ICU-level COVID-19 rates

Remark

INSPIRATION, 2021 NCT04486508

anticoagulation, intermediate prophylactic dose (n=276) vs. anticoagulant, prophylactic dose (n=286)

randomized controlled trial   some concerns about risk of bias

Studied treatment

intermediate-dose prophylactic anticoagulation
enoxaparin, 1mg/kg daily

Control treatment

standard-dose prophylactic anticoagulation
enoxaparin, 40mg daily

Patients

COVID-19 severe or critically

Method

open-label

10 academic centers in Iran

2 × 2 factorial design comparing intermediate-dose vs standard-dose prophylactic anticoagulation and statin therapy vs matching placebo

Remark