This prospective, randomized, open-label, multi-center interventional study is designed to compare the safety and efficacy of two LMWH dosing protocols in patients admitted to the University of Iowa Hospitals with COVID-19 who meet the modified ISTH Overt DIC criteria score ≥3. Patients will be randomized to standard prophylactic dose LMWH (standard of care arm) or intermediate-dose LMWH (intervention arm).
Who can participate
Age range18 Years – 100 Years
SexALL
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Inclusion Criteria:
* Laboratory confirmed SARS-CoV-2 infection
* Age ≥18 years
* Requires hospital admission for further clinical management
* Modified ISTH Overt DIC score ≥ 3
Exclusion Criteria:
* Indication for full therapeutic-dose anticoagulation
* Acute venous thromboembolism (deep vein thrombosis or pulmonary embolism) within prior 3 months
* Acute cardiovascular event within prior 3 months
* Acute stroke (ischemic or hemorrhagic) within prior 3 months
* Active major bleeding
* Severe thrombocytopenia (\<25,000/mm3)
* Increased risk of bleeding, as assessed by the investigator
* Acute or chronic renal insufficiency with Creatinine Clearance \< 30 ml/min calculated by the modified Cockcroft and Gault formula
* Weight \< 40 kg
* Known allergies to ingredients contained in enoxaparin, allergy to heparin products or history of heparin induced thrombocytopenia