Overview
Hypercoagulability has been demonstrated in COVID-19, leading to respiratory distress and increased mortality. This is adaptive clinical trial to compare effectiveness and safety of four therapeutic strategies in hospital mortality in patients with COVID-19: standard prophylaxis, therapeutic dose anticoagulation, inhaled UFH associated with standard prophylaxis and ASA associated with standard prophylaxis.
Eligibility
Inclusion Criteria:
- Adult 18 years of age at time of enrollment
- Subjects with a positive COVID-19 diagnosis by RT-PCR or serologic testing
- Subject (or legally authorized representative) must be willing, understanding and able to provide written informed consent.
Exclusion Criteria:
- General
- Indications for therapeutic anticoagulation
- History of chronic lung disease oxygen dependent
- Pregnancy
- Death considered imminent and inevitable within 24 hours
- Patients under exclusive palliative care
- Participation in another trial of investigational drug
- Body weight < 40 Kg
- Total bilirubin > 20 mg/dL
- Severe active bleeding
- Known allergy to UFH or LMWH
- History of heparin-induced thrombocytopenia (HIT) within the past 6 months
- Bacterial endocarditis
- Exclusion criteria at phase 1
Platelets < 25,000
3. Exclusion criteria at phase 2
- Platelets < 50,000
- History of surgery in the last 30 days
- Intervention C: allergy to ASS and long-term use of antiplatelet drug