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The aims of the study are to to associate anticoagulation (AC) regime with outcome in critically ill patients with Covid-19. This will be done by describe baseline characteristics and comorbidities before hospital admission, level of organ support and dose of AC treatment and associate this with 28 days survival, survival outside ICU, thromboembolic event and bleeding complications.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| thrombose prophylaxis | The dose used to prevent thromboembolic complication in critically ill |
| |
| double thrombose prophylaxis | Double the dose used to prevent thromboembolic complication in critically ill |
| |
| full dose anticoagulant | Dose used to treat thromboembolic event |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Dose of Tinzaparin or Dalteparin | Drug | The patients will be categorised into three groups depending on initial regime of anticoagulants after arrival in the ICU. |
|
| Measure | Description | Time Frame |
|---|---|---|
| 28-days ICU mortality | 28-days ICU mortality from admission to the ICU. Discontinue of ICU-care to palliative care counts as death. | 28 days from ICU-admission |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of thromboembolic events | Thromboembolic events are defined as pulmonary emboli (PE), deep venous thrombus (DVT), ischemic stroke and other peripheral arterial emboli. PE is defined as PE verified by computer tomography or by findings of acute strain of the right heart on echocardiography combined with a clinical interpretation of the patients deteriorating as a probable PE stated in the medical records. DVT is defined as DVT verified with ultrasound. Ischemic stroke is defined as ischemic stroke verified by computer tomography. Peripheral arterial emboli are defined as peripheral arterial emboli verified by computer tomography. |
| Measure | Description | Time Frame |
|---|---|---|
| D-dimer levels in the three groups groups | D-dimer every day it is measured during first 28 days from ICU-admission. | 28 days from ICU-admission |
Inclusion Criteria:
Exclusion Criteria:
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A cohort study of the Covid-19 patients admitted to an ICU at Stockholm South General Hospital from March 6th 2020 to April 30 2020
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| Name | Affiliation | Role |
|---|---|---|
| Maria Cronhjort, PhD | Karolinska Institutet, Department of Clinical Science and Education | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| South General Hospital | Stockholm | Stockholm County | 11880 | Sweden |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 33225952 | Derived | Jonmarker S, Hollenberg J, Dahlberg M, Stackelberg O, Litorell J, Everhov AH, Jarnbert-Pettersson H, Soderberg M, Grip J, Schandl A, Gunther M, Cronhjort M. Dosing of thromboprophylaxis and mortality in critically ill COVID-19 patients. Crit Care. 2020 Nov 23;24(1):653. doi: 10.1186/s13054-020-03375-7. |
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| ID | Term |
|---|---|
| D000086382 | COVID-19 |
| D013923 | Thromboembolism |
| D006470 | Hemorrhage |
| ID | Term |
|---|---|
| D011024 | Pneumonia, Viral |
| D011014 | Pneumonia |
| D012141 | Respiratory Tract Infections |
| D007239 | Infections |
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| ID | Term |
|---|---|
| D017985 | Dalteparin |
| ID | Term |
|---|---|
| D006495 | Heparin, Low-Molecular-Weight |
| D006493 | Heparin |
| D006025 | Glycosaminoglycans |
| D011134 | Polysaccharides |
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| 28 days from ICU-admission |
| Incidence of bleeding events | The event of bleeding will be defined by WHO modified bleeding scale as 1-4. | 28 days from ICU-admission |
| ICU-free days alive from ICU-admission. | ICU-free days alive during 28 days from ICU-admission. Counts as 0 days if discharged to ward for palliative treatment. | 28 days from ICU-admission |
| D014777 |
| Virus Diseases |
| D018352 | Coronavirus Infections |
| D003333 | Coronaviridae Infections |
| D030341 | Nidovirales Infections |
| D012327 | RNA Virus Infections |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D016769 | Embolism and Thrombosis |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D002241 |
| Carbohydrates |