Status:

UNKNOWN

High Versus Low LMWH Dosages in Hospitalized Patients With Severe COVID-19 Pneumonia and Coagulopathy

Lead Sponsor:

Azienda Ospedaliero-Universitaria di Modena

Conditions:

COVID

Pneumonia, Viral

Eligibility:

All Genders

18-80 years

Phase:

PHASE3

Brief Summary

Randomized, controlled study conducted in hospitalized patients with severe COViD-19 pneumonia and coagulopathy not requiring invasive mechanical ventilation. Aim of this study is to assess whether h...

Detailed Description

This is a multicentre, randomised controlled, open label, investigator sponsored, two arms study. The study will involve 7 Italian Academic and non-Academic Internal Medicine Units, 2 Infectious Dise...

Eligibility Criteria

Inclusion

  • Inclusion Criteria (all required):
  • Positive SARS-CoV-2 diagnostic (on pharyngeal swab of deep airways material)
  • Severe pneumonia defined by the presence of at least one of the following criteria:
  • Respiratory Rate ≥25 breaths /min
  • Arterial oxygen saturation≤93% at rest on ambient air
  • PaO2/FiO2 ≤300 mmHg
  • Coagulopathy, defined by the presence of at least one of the following criteria:
  • D-dimer \>4 times the upper level of normal reference range
  • Sepsis-Induced Coagulopathy (SIC) score \>4
  • No need for invasive mechanical ventilation
  • Exclusion Criteria:
  • Invasive mechanical ventilation
  • Thrombocytopenia (platelet count \< 80.000 mm3)
  • Coagulopathy: INR \>1.5, aPTT ratio \> 1.4
  • Impaired renal function (eGFR calculated by CKD-EPI Creatinine equation \< 30 ml/min)
  • Known hypersensitivity to enoxaparin
  • History of heparin induced thrombocytopenia
  • Presence of an active bleeding or a pathology susceptible of bleeding in presence of anticoagulation (e.g. recent haemorrhagic stroke, peptic ulcer, malignant cancer at high risk of haemorrhage, recent neurosurgery or ophthalmic surgery, vascular aneurysms, arteriovenous malformations)
  • Concomitant anticoagulant treatment for other indications (e.g. atrial fibrillation, venous thromboembolism, prosthetic heart valves).
  • Concomitant double antiplatelet therapy
  • Administration of therapeutic doses of LMWH, fondaparinux, or unfractionated heparin (UFH) for more than 72 hours before randomization; prophylactic doses are allowed
  • Pregnancy or breastfeeding or positive pregnancy test
  • Presence of other severe diseases impairing life expectancy (e.g. patients are not expected to survive 28 days given their pre-existing medical condition)
  • Lack or withdrawal of informed consent

Exclusion

    Key Trial Info

    Start Date :

    June 1 2020

    Trial Type :

    INTERVENTIONAL

    Allocation :

    ESTIMATED

    End Date :

    June 1 2021

    Estimated Enrollment :

    300 Patients enrolled

    Trial Details

    Trial ID

    NCT04408235

    Start Date

    June 1 2020

    End Date

    June 1 2021

    Last Update

    May 29 2020

    Active Locations (1)

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    Azienda Ospedaliero-Universitaria

    Modena, Italy, 41124

    High Versus Low LMWH Dosages in Hospitalized Patients With Severe COVID-19 Pneumonia and Coagulopathy | DecenTrialz