The intermediate-dose when compared to the standard-dose prophylactic anticoagulation therapy didn't minimize extracorporeal membrane oxygenation (ECMO) therapy, thrombosis, and mortality in critically ill patients infected with the coronavirus.

Thrombosis is regarded as one of the major extrapulmonary indications of COVID-19. An open-label randomized controlled trial (INSPIRATION) aimed to examine the ideal type and duration of the preventive antithrombotic therapy in COVID-19 patients with thrombosis admitted to the critical care unit.

In total, 600 participants were subjected to either intermediate-dose or standard-dose prophylactic anticoagulation for 30 days, regardless of the hospital discharge status. Composite of adjudicated venous or arterial thrombosis, ECMO treatment, or all-cause mortality was the primary endpoint. Major bleeding was the main safety endpoint.

Five hundred and sixty-two participants entered the modified intention-to-treat assessment, of whom 336 (59.8%) endured hospital discharge. The occurrence of primary endpoint and major bleeding events in subjects allocated to intermediate-dose and the standard-dose anticoagulation group is illustrated in the table below:

At 90-day follow-up, the intermediate dose did not decrease composite of death, ECMO treatment, or venous or arterial thrombosis as compared to the standard-dose prophylactic anticoagulation.