Effect of Intermediate-Dose vs Standard-Dose Prophylactic Anticoagulation on Thrombotic Events, Extracorporeal Membrane Oxygenation Treatment, or Mortality Among Patients With COVID-19 Admitted to the Intensive Care Unit: The INSPIRATION Randomized Clinical Trial

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

<p class="first" id="d5851097e883">Thrombotic events are commonly reported in critically ill patients with COVID-19. Limited data exist to guide the intensity of antithrombotic prophylaxis. </p>

Related collections

Most cited references 37

Record: found
Abstract: found
Article: not found

Dexamethasone in Hospitalized Patients with Covid-19 — Preliminary Report

Mark Peters (2021)

Abstract Background Coronavirus disease 2019 (Covid-19) is associated with diffuse lung damage. Glucocorticoids may modulate inflammation-mediated lung injury and thereby reduce progression to respiratory failure and death. Methods In this controlled, open-label trial comparing a range of possible treatments in patients who were hospitalized with Covid-19, we randomly assigned patients to receive oral or intravenous dexamethasone (at a dose of 6 mg once daily) for up to 10 days or to receive usual care alone. The primary outcome was 28-day mortality. Here, we report the preliminary results of this comparison. Results A total of 2104 patients were assigned to receive dexamethasone and 4321 to receive usual care. Overall, 482 patients (22.9%) in the dexamethasone group and 1110 patients (25.7%) in the usual care group died within 28 days after randomization (age-adjusted rate ratio, 0.83; 95% confidence interval [CI], 0.75 to 0.93; P<0.001). The proportional and absolute between-group differences in mortality varied considerably according to the level of respiratory support that the patients were receiving at the time of randomization. In the dexamethasone group, the incidence of death was lower than that in the usual care group among patients receiving invasive mechanical ventilation (29.3% vs. 41.4%; rate ratio, 0.64; 95% CI, 0.51 to 0.81) and among those receiving oxygen without invasive mechanical ventilation (23.3% vs. 26.2%; rate ratio, 0.82; 95% CI, 0.72 to 0.94) but not among those who were receiving no respiratory support at randomization (17.8% vs. 14.0%; rate ratio, 1.19; 95% CI, 0.91 to 1.55). Conclusions In patients hospitalized with Covid-19, the use of dexamethasone resulted in lower 28-day mortality among those who were receiving either invasive mechanical ventilation or oxygen alone at randomization but not among those receiving no respiratory support. (Funded by the Medical Research Council and National Institute for Health Research and others; RECOVERY ClinicalTrials.gov number, NCT04381936; ISRCTN number, 50189673.)

0 comments Cited 4914 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Pulmonary Vascular Endothelialitis, Thrombosis, and Angiogenesis in Covid-19

Maximilian Ackermann, Stijn Verleden, Mark Kuehnel … (2020)

Progressive respiratory failure is the primary cause of death in the coronavirus disease 2019 (Covid-19) pandemic. Despite widespread interest in the pathophysiology of the disease, relatively little is known about the associated morphologic and molecular changes in the peripheral lung of patients who die from Covid-19.

0 comments Cited 2861 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: found

Baseline Characteristics and Outcomes of 1591 Patients Infected With SARS-CoV-2 Admitted to ICUs of the Lombardy Region, Italy

Giacomo Grasselli, Alberto Zangrillo, Alberto Zanella … (2020)

In December 2019, a novel coronavirus (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) emerged in China and has spread globally, creating a pandemic. Information about the clinical characteristics of infected patients who require intensive care is limited.

0 comments Cited 2790 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Journal

Title: JAMA

Abbreviated Title: JAMA

Publisher: American Medical Association (AMA)

ISSN (Print): 0098-7484

Publication date (Electronic): March 18 2021

Affiliations

[1 ]Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran

[2 ]Clinical Trial Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran

[3 ]Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran

[4 ]Tuberclosis and Lung Diseases Research Center, Tabriz, Iran

[5 ]Tobacoo Prevention and control Research center, National Research institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran

[6 ]Lung Transplantation Research Center, Department of Cardiology, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran

[7 ]Anesthesiology and Intensive Care, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

[8 ]Firouzgar hospital, Department of internal medicine, Iran University of Medical Sciences, Tehran, Iran

[9 ]Research Center for Prevention of Cardiovascular Disease, Institute of Endocrinology & Metabolism, Iran University of Medical Sciences, Tehran, Iran

[10 ]Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran

[11 ]Department of Anesthesiology, School of Medicine Anesthesiology Research Center Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

[12 ]School of Medicine, Department of Internal Medicine, Shariati Hospital, Tehran, Iran

[13 ]Student Research Committee, Iran University of Medical Sciences, Tehran, Iran

[14 ]Department of Pharmacotherapy, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

[15 ]Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran

[16 ]Chronic Respiratory Disease Research Center, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

[17 ]Department of Pharmacotherapy, Faculty of Pharmacy, Kermanshah University of Medical Sciences, Kermanshah, Iran

[18 ]School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran

[19 ]Rajaie Cardiovascular Medical and Research Center, Iran university of Medical sciences, Tehran, Iran

[20 ]School of Medicine, Department of Pulmonary and Critical Care, Shariati Hospital, Tehran, Iran

[21 ]Advanced Thoracic Research Center, Tehran University of Medical Sciences, Tehran, Iran

[22 ]Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

[23 ]Shahid Dr Labbafinejad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

[24 ]Respiratory Department, Hospital Ramón y Cajal (IRYCIS), Madrid, Spain

[25 ]Medicine Department, Universidad de Alcalá (IRYCIS), Madrid, Spain

[26 ]CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain

[27 ]Cardiovascular Research Foundation (CRF), New York, New York

[28 ]Division of Cardiology, Columbia University Irving Medical Center/NewYork-Presbyterian Hospital, New York, New York

[29 ]Yale/YNHH Center for Outcomes Research & Evaluation, New Haven, Connecticut

[30 ]Department of Internal Medicine, Hospital Germans Trias i Pujol, Badalona, Barcelona, Universidad Católica de Murcia, Murcia, Spain

[31 ]Cardiovascular Medicine Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts

[32 ]School of Pharmacy, Department of Pharmacotherapy and Outcome Science, Virginia Commonwealth University, Richmond, Virginia

[33 ]School of Pharmacy, Pauley Heart Center, Division of Cardiology, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia

[34 ]College of Pharmacy, University of Nebraska Medical Center, Omaha

[35 ]The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York

[36 ]Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom

[37 ]Aalborg University, Aalborg, Denmark

[38 ]Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut

[39 ]Department of Health Policy and Administration, Yale School of Public Health, New Haven, Connecticut

Article

DOI: 10.1001/jama.2021.4152

PMC ID: 7974835

PubMed ID: 33734299

SO-VID: 29888d05-39c8-473a-950d-6c032d8bc95c

History

Data availability:

Comments

Comment on this article

scite_

Cited by 322

See all cited by

Most referenced authors 1,776

See all reference authors

Effect of Intermediate-Dose vs Standard-Dose Prophylactic Anticoagulation on Thrombotic Events, Extracorporeal Membrane Oxygenation Treatment, or Mortality Among Patients With COVID-19 Admitted to the Intensive Care Unit : The INSPIRATION Randomized Clinical Trial

Read this article at

Abstract

Related collections

Novel Coronavirus Disease COVID-19

Most cited references 37

Dexamethasone in Hospitalized Patients with Covid-19 — Preliminary Report

Pulmonary Vascular Endothelialitis, Thrombosis, and Angiogenesis in Covid-19

Baseline Characteristics and Outcomes of 1591 Patients Infected With SARS-CoV-2 Admitted to ICUs of the Lombardy Region, Italy

Author and article information

Journal

Affiliations

Article

History

Comments

Comment on this article

Similar content 664

Cited by 322

Most referenced authors 1,776