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dc.contributor.advisorBrækkan, Sigrid Kufaas
dc.contributor.authorArnesen, Carl Arne Løchen
dc.date.accessioned2024-05-31T12:22:30Z
dc.date.available2024-05-31T12:22:30Z
dc.date.issued2022-05-31en
dc.description.abstractBackground: Coronavirus disease 2019 (COVID-19) is known to increase the risk of venous thromboembolism (VTE), and studies have shown a three-fold increase in VTE-risk in hospitalized COVID-19 patients compared to similar respiratory infections. Standard dose thromboprophylaxis is recommended in all hospitalized COVID-19 patients. However, despite prophylaxis, VTE incidence remains high. Several randomized controlled trials (RCTs) have studied the effect of escalated doses of thromboprophylaxis, but they have produced conflicting results, and have not been adequately powered to assess the outcomes VTE, major bleeding and all-cause mortality. Aim: To conduct a literature review and meta-analysis of RCTs, comparing the effect of escalated versus standard doses of prophylactic anticoagulation in hospitalized COVID-19 patients admitted to an intensive care unit (ICU) or non-ICU, focusing on VTE, major bleeding and all-cause mortality. Methods: A structured literature search was performed to retrieve RCTs investigating the safety and efficacy of escalated versus standard doses of prophylactic anticoagulation in hospitalized COVID-19-patients. The trials were analyzed in overall populations, and subgroups based on clinical setting (ICU/non-ICU). Risk ratios (RRs) with 95% Confidence intervals (95% CI) for VTE, death and major bleeding were extracted, and pooled results were calculated and displayed in forest plots. Results: In the meta-analysis, 9 RCTs were included (n=5,658). Compared to standard dose, escalated dose prophylactic anticoagulation was associated with an overall reduction in VTE risk (RR: 0.49, 95% CI: 0.38-0.64), an increase in major bleeding risk (RR: 1.76, 95% CI: 1.19-2.59) and no difference in mortality (RR: 0.98, 95% CI: 0.88-1.09). In subgroup analysis based on clinical setting, estimates indicated a further reduction in VTE risk and all-cause mortality in non-ICU-patients compared to ICU-patients. However, these differences did not reach statistical significance. Conclusion: Escalated doses of prophylactic anticoagulation was associated with a reduction in VTE-risk, increased major bleeding and no effect on all-cause mortality.en_US
dc.identifier.urihttps://hdl.handle.net/10037/33666
dc.language.isoengen_US
dc.publisherUiT Norges arktiske universitetno
dc.publisherUiT The Arctic University of Norwayen
dc.rights.holderCopyright 2022 The Author(s)
dc.rights.urihttps://creativecommons.org/licenses/by-nc-sa/4.0en_US
dc.rightsAttribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0)en_US
dc.subject.courseIDMED-3950
dc.subjectVDP::Medisinske Fag: 700::Helsefag: 800::Epidemiologi medisinsk og odontologisk statistikk: 803en_US
dc.subjectVDP::Medical disciplines: 700::Health sciences: 800::Epidemiology medical and dental statistics: 803en_US
dc.subjectVDP::Medisinske Fag: 700::Helsefag: 800::Forebyggende medisin: 804en_US
dc.subjectVDP::Medical disciplines: 700::Health sciences: 800::Preventive medicine: 804en_US
dc.titleEfficacy and safety of escalated versus standard prophylactic anticoagulation in patients with Covid-19: A literature review and meta-analysisen_US
dc.typeMaster thesisen
dc.typeMastergradsoppgaveno


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Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0)
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