{"doi":"10.1016/j.jacc.2021.12.023","title":"Anticoagulation in Patients With COVID-19","abstract":"Clinical, laboratory, and autopsy findings support an association between coronavirus disease-2019 (COVID-19) and thromboembolic disease. Acute COVID-19 infection is characterized by mononuclear cell reactivity and pan-endothelialitis, contributing to a high incidence of thrombosis in large and small blood vessels, both arterial and venous. Observational studies and randomized trials have investigated whether full-dose anticoagulation may improve outcomes compared with prophylactic dose heparin. Although no benefit for therapeutic heparin has been found in patients who are critically ill hospitalized with COVID-19, some studies support a possible role for therapeutic anticoagulation in patients not yet requiring intensive care unit support. We summarize the pathology, rationale, and current evidence for use of anticoagulation in patients with COVID-19 and describe the main design elements of the ongoing FREEDOM COVID-19 Anticoagulation trial, in which 3,600 hospitalized patients with COVID-19 not requiring intensive care unit level of care are being randomized to prophylactic-dose enoxaparin vs therapeutic-dose enoxaparin vs therapeutic-dose apixaban. (FREEDOM COVID-19 Anticoagulation Strategy [FREEDOM COVID]; NCT04512079).","journal":"Journal of the American College of Cardiology","year":2022,"id":237748,"datarank":2.0240217850701363,"base_score":4.07753744390572,"endowment":4.07753744390572,"self_citation_contribution":0.611630616585858,"citation_network_contribution":1.412391168484278,"self_endowment_contribution":0.611630616585858,"citer_contribution":1.412391168484278,"corpus_percentile":null,"corpus_rank":null,"citation_count":58,"citer_count":54,"citers_with_citation_signal":39,"citers_with_endowment":39,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9599,"is_data_producer":true,"deposit_databanks":{"ClinicalTrials.gov":["NCT04512079"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":104011,"name":"Gregg W. Stone","orcid":"0000-0002-3416-8210","position":1,"is_corresponding":false},{"id":108634,"name":"Anuradha Lala","orcid":"0000-0001-6479-6958","position":2,"is_corresponding":false},{"id":108645,"name":"Emilia Bagiella","orcid":"0000-0002-3582-6502","position":3,"is_corresponding":false},{"id":227539,"name":"Pedro Moreno","orcid":"0000-0003-3745-5845","position":4,"is_corresponding":false},{"id":5026,"name":"Girish N. Nadkarni","orcid":"0000-0001-6319-4314","position":5,"is_corresponding":false},{"id":254522,"name":"Ori Ben‐Yehuda","orcid":"0000-0001-9199-1660","position":6,"is_corresponding":false},{"id":51562,"name":"Juan F. Granada","orcid":"0000-0003-2399-8320","position":7,"is_corresponding":false},{"id":860628,"name":"Ovidiu Dressler","orcid":"0000-0001-8358-9073","position":8,"is_corresponding":false},{"id":861246,"name":"Elizabeth Tinuoye","orcid":null,"position":9,"is_corresponding":false},{"id":861247,"name":"Carlos Granada","orcid":null,"position":10,"is_corresponding":false},{"id":861248,"name":"Jessica Bustamante","orcid":null,"position":11,"is_corresponding":false},{"id":861249,"name":"Carlos Peyra","orcid":null,"position":12,"is_corresponding":false},{"id":802950,"name":"Lucas C. Godoy","orcid":"0000-0001-6171-1269","position":13,"is_corresponding":false},{"id":472964,"name":"Igor F. Palacios","orcid":"0000-0001-9117-1339","position":14,"is_corresponding":false},{"id":103423,"name":"Valentı́n Fuster","orcid":"0000-0002-9043-9986","position":15,"is_corresponding":false},{"id":227543,"name":"Michael E. Farkouh","orcid":"0000-0002-8095-0246","position":0,"is_corresponding":true}],"reference_count":60,"raw_metadata":null,"created_at":"2026-07-19T00:22:21.693802Z","pmid":"35241226","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}