Source: global medicine compilation time: September 18, 2021
Most novel coronavirus pneumonia patients are moderately ill and initially do not need organ support in ICU. Novel coronavirus pneumonia was used in the study of N Engl J Med in August 2021. Researchers in Canada, the United States and Brazil published ancient Chinese literature search for the anticoagulant treatment outcome of heparin anticoagulation therapy in non severe patients with new crown pneumonia.
Background: novel coronavirus pneumonia is associated with death and complications due to thrombosis and inflammation. The researchers hypothesized novel coronavirus pneumonia could improve the outcome of non critical hospitalized patients with new crown pneumonia.
Methods: novel coronavirus pneumonia (non organ support), defined as non critical care level, was randomly assigned to 2 practical definitions: heparin anticoagulation or regular thrombus prophylaxis in this open, adaptive, multi platform, controlled trial. The primary outcome was the number of days without organ support, assessed by a sequential scale that combined in-hospital death (score - 1) and the number of days of patients who survived to discharge without cardiovascular or respiratory organ support up to day 21. All patient outcomes were assessed using Bayesian statistical models and based on baseline D-dimer levels.
Results: when the therapeutic dose of anticoagulation met the preset superiority criteria, the test was stopped. Among the 2219 patients in the final analysis, the probability of treatment dose anticoagulation increasing the number of days without organ support compared with conventional thromboprophylaxis was 98.6% (adjusted or, 1.27; 95% CI, 1.03 ~ 1.58). The absolute difference between groups in the adjustment of survival to discharge without organ support showed that the therapeutic dose of anticoagulation was better, and the difference between the two groups was 4.0% (0.5 ~ 7.2). The final probability of the superiority of therapeutic dose anticoagulation over conventional thromboprophylaxis was 97.3%, 92.9% and 97.3% in high D-dimer cohort, low D-dimer cohort and unknown D-dimer cohort, respectively. Massive hemorrhage occurred in 1.9% and 0.9% of the patients in the treatment dose anticoagulation group and thrombosis prevention group, respectively.
Conclusion: novel coronavirus pneumonia strategy can increase the probability of survival and discharge and reduce the use of cardiovascular or respiratory support in patients with non severe new crown pneumonia.
Post time: Sep-18-2021