Pattern of anticoagulation prescription for patients with Covid-19 acute respiratory distress syndrome admitted to ICU. Does it impact outcome?

This was a single-center retrospective chart review, so anticoagulation was not assigned randomly and dose changes reflected clinician judgment. The sample was small and relatively young, and it included Asian patients, so the results may not apply to other communities. The dosing-pattern table reports 147 patients while the overall sample is 149, so the number analysed for dose patterns is not fully explained. DVT and PE were not actively screened, and no post-mortem studies were done, so true rates may be higher than documented. Bleeding and thrombosis events were too few to compare among anticoagulation groups. Many patients received other treatments, including antivirals, steroids, chloroquine, favipiravir, mechanical ventilation, vasopressors, and dialysis, which may have influenced outcomes. Lactate results may not apply to other populations because sodium bicarbonate was used liberally before ICU admission.

No financial support was reported. All authors declared no conflicts of interest.

Do not conclude that changing anticoagulant doses is ineffective or safe. This was a small retrospective study, and DVT and PE were not actively screened, so the absence of documented events does not prove low risk.