REMAP-CAP / ATTACC / ACTIV-4a
Therapeutic-Dose Heparin in COVID-19
Patient / Population Intervention / Exposure Comparison Outcome
In hospitalised COVID-19 patients across three coordinated platforms, therapeutic-dose heparin improved organ-support-free days in moderate illness but not in critically ill patients.
N
3,398
Design
Coordinated multi-platform RCT
Endpoint
Organ-support-free days at 21 days
Relevance
2
ResultModerate-illness benefit; critically ill futility — possible harm.
ATTACC, ACTIV-4a, REMAP-CAP Investigators. N Engl J Med. 2021;385(9):790-802 and 385(9):777-789. 10.1056/NEJMoa2105911
Discussion & critique
Defined the moderate-vs-severe split for therapeutic anticoagulation in COVID-19.