Early initiation of prophylactic anticoagulation for prevention of COVID-19 mortality in patients admitted to hospital in the United States

Investigators explored a potential association between early introduction of prophylactic anticoagulation and reduced mortality in U.S. patients with COVID-19. The observational cohort study included 4,297 Department of Veterans Affairs patients hospitalized from March through July 2020, all of whom were diagnosed with COVID-19 and none with a history of anticoagulation. The overwhelming majority, 3,627 patients, underwent prophylactic anticoagulation within 24 hours of being admitted to the hospital—primarily with heparin. A total of 622 patients died within 30 days of admission, including 513 in the prophylactic anticoagulation group. Using inverse probability of treatment weighted analyses, researchers calculated 30-day mortality among COVID-19 patients who did and did not receive prophylactic anticoagulation soon after hospital admission. The incidence rates were 14.3% and 18.7%, respectively, for a difference of 4.4% in favor of prophylactic anticoagulation. The intervention was not linked to an increased risk of serious bleeding events, furthering the argument supporting its use in this setting.