Research and Practice in Thrombosis and Haemostasis (Jul 2024)
Long-term course of ambulatory patients with COVID-19 initially treated with enoxaparin vs no anticoagulation: final analysis of the OVID (enoxaparin for outpatients with COVID-19) randomized trial
- Riccardo M. Fumagalli,
- Davide Voci,
- Behnood Bikdeli,
- Roland Bingisser,
- Giuseppe Colucci,
- Gabor Forgo,
- Teresa Gerardi,
- Bernhard Gerber,
- Alexandru Grigorean,
- Frederikus A. Klok,
- Marc Righini,
- Helia Robert-Ebadi,
- Stefan Stortecky,
- Silvia Ulrich,
- Simon Wolf,
- Dörte Wyss,
- Lukas Hobohm,
- Nils Kucher,
- Stefano Barco,
- Stefano Barco,
- Davide Voci,
- Ulrike Held,
- Tim Sebastian,
- Roland Bingisser,
- Giuseppe Colucci,
- Daniel Duerschmied,
- André Frenk,
- Bernhard Gerber,
- Andrea Götschi,
- Stavros V. Konstantinides,
- François Mach,
- Helia Robert-Ebadi,
- Thomas Rosemann,
- Noemi R. Simon,
- Hervé Spechbach,
- David Spirk,
- Stefan Stortecky,
- Lukas Vaisnora,
- Marc Righini,
- Nils Kucher,
- Stéphanie Roth Zetzsche,
- Rebecca Spescha,
- Claudia Leeger,
- Yulia Butscheid,
- Eliane Probst,
- Evy Micieli,
- Gabor Forgo,
- Fabian Johner,
- Alexandru Grigorean,
- Georgios Vatsakis,
- Dagmar Keller Lang,
- Silvana Rampini Speck,
- Barbara Hasse,
- Marco Rueegg,
- Isabelle Arnold,
- Christian Nickel,
- Jeannette Busch,
- Marc Blondon,
- Frédéric Glauser,
- Micol G. Cittone,
- Chiara Kessler,
- Diona Gjermeni,
- Christoph B. Olivier,
- Nadine Gauchel,
- Paul Biever,
- Lukas Hobohm,
- Dorothea Becker,
- Marc Schindewolf,
- Arnaud Kuenzi,
- Silvia Ulrich
Affiliations
- Riccardo M. Fumagalli
- Department of Angiology, University Hospital Zurich, Zurich, Switzerland; University of Zurich, Zurich, Switzerland
- Davide Voci
- Department of Angiology, University Hospital Zurich, Zurich, Switzerland
- Behnood Bikdeli
- Thrombosis Research Group, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA; Cardiovascular Medicine Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Roland Bingisser
- Emergency Department, University Hospital Basel, Basel, Switzerland
- Giuseppe Colucci
- Service of Hematology, Clinica Luganese Moncucco, Lugano, Switzerland; University of Basel, Basel, Switzerland; Clinica Sant’Anna, Sorengo, Switzerland
- Gabor Forgo
- Department of Angiology, University Hospital Zurich, Zurich, Switzerland
- Teresa Gerardi
- Clinic of Hematology, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
- Bernhard Gerber
- University of Zurich, Zurich, Switzerland; Clinic of Hematology, Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
- Alexandru Grigorean
- Department of Angiology, University Hospital Zurich, Zurich, Switzerland
- Frederikus A. Klok
- Department of Medicine, Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands
- Marc Righini
- Division of Angiology and Hemostasis, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
- Helia Robert-Ebadi
- Division of Angiology and Hemostasis, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
- Stefan Stortecky
- Department of Cardiology, Inselspital Bern, University of Bern, Bern, Switzerland
- Silvia Ulrich
- Department of Pulmonology, University Hospital of Zurich, Zurich, Switzerland
- Simon Wolf
- Department of Angiology, University Hospital Zurich, Zurich, Switzerland
- Dörte Wyss
- Department of Angiology, University Hospital Zurich, Zurich, Switzerland
- Lukas Hobohm
- Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; Department of Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
- Nils Kucher
- Department of Angiology, University Hospital Zurich, Zurich, Switzerland; University of Zurich, Zurich, Switzerland
- Stefano Barco
- Department of Angiology, University Hospital Zurich, Zurich, Switzerland; University of Zurich, Zurich, Switzerland; Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; Correspondence Stefano Barco, Department of Angiology, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland.
- Stefano Barco
- Davide Voci
- Ulrike Held
- Tim Sebastian
- Roland Bingisser
- Giuseppe Colucci
- Daniel Duerschmied
- André Frenk
- Bernhard Gerber
- Andrea Götschi
- Stavros V. Konstantinides
- François Mach
- Helia Robert-Ebadi
- Thomas Rosemann
- Noemi R. Simon
- Hervé Spechbach
- David Spirk
- Stefan Stortecky
- Lukas Vaisnora
- Marc Righini
- Nils Kucher
- Stéphanie Roth Zetzsche
- Rebecca Spescha
- Claudia Leeger
- Yulia Butscheid
- Eliane Probst
- Evy Micieli
- Gabor Forgo
- Fabian Johner
- Alexandru Grigorean
- Georgios Vatsakis
- Dagmar Keller Lang
- Silvana Rampini Speck
- Barbara Hasse
- Marco Rueegg
- Isabelle Arnold
- Christian Nickel
- Jeannette Busch
- Marc Blondon
- Frédéric Glauser
- Micol G. Cittone
- Chiara Kessler
- Diona Gjermeni
- Christoph B. Olivier
- Nadine Gauchel
- Paul Biever
- Lukas Hobohm
- Dorothea Becker
- Marc Schindewolf
- Arnaud Kuenzi
- Silvia Ulrich
- Journal volume & issue
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Vol. 8,
no. 5
p. 102534
Abstract
Background: Early thromboprophylaxis does not prevent hospital admissions and death among outpatients with symptomatic COVID-19. Its impact on long-term outcomes, including long COVID symptoms and performance status, is unknown. Objectives: To assess the long-term effects of thromboprophylaxis given at the time of acute COVID-19 in outpatients. Methods: The OVID (enoxaparin for outpatients with COVID-19) trial randomized outpatients older than 50 years with acute COVID-19 to receive either subcutaneous enoxaparin 40 mg once daily for 14 days or standard of care (no thromboprophylaxis). In this follow-up study, we assessed the 2-year outcomes, including all-cause hospitalization and death, cardiovascular events, long COVID symptoms, and functional limitations based on the Post–COVID-19 Functional Status (PCFS) scale and EuroQol-5 Dimensions-5 Levels scale. Results: Of 469 potentially eligible patients, 468 survived, of whom 439 (mean age 59 years; 54% men) participated in the Post-OVID study. There was no difference in terms of hospitalization and death (8.3% in the treatment group vs 10% in controls; relative risk, 0.83; 95% CI, 0.5-1.5) and of cardiovascular events between groups. The risk of presenting with long COVID symptoms was similar in the 2 groups (44% in the treatment group vs 47% in the standard of care group), with no difference between groups also concerning individual symptoms. A PCFS grade of 1 to 3, indicating light-to-moderate functional limitation, was recorded in 15% of patients in each group (odds ratio, 0.98; 95% CI, 0.6-1.7). No patients reported severe limitations (PCFS grade 4). Median EuroQol visual analog scale score was 85 on 100 points (IQR, 80-90 for the standard of care group and 75-90 for the enoxaparin group). Conclusion: Early thromboprophylaxis does not improve long-term, 2-year clinical and functional outcomes among symptomatic ambulatory patients with acute COVID-19.
