Enoxaparin is associated with lower rates of mortality than unfractionated Heparin in hospitalized COVID-19 patients

  1. Colin Pawlowski
  2. AJ Venkatakrishnan
  3. Christian Kirkup
  4. Gabriela Berner
  5. Arjun Puranik
  6. John C. O'Horo
  7. Andrew D. Badley
  8. Venky Soundararajan

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Abstract

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  1. ScreenIT

    SciScore for 10.1101/2020.10.06.20208025: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: Study Design: This research was conducted under IRB 20-003278, “Study of COVID-19 patient characteristics with augmented curation of Electronic Health Records (EHR) to inform strategic and operational decisions”, approved by the Mayo Clinic’s institutional review board (IRB).
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    This was done using the stats.chi2_contingency function of the scipy python package.
    scipy
    suggested: (SciPy, RRID:SCR_008058)
    python
    suggested: (IPython, RRID:SCR_001658)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    A few caveats are in order. Compounding this limitation, enoxaparin and heparin differ in FDA label indications. The label for enoxaparin13 includes the prophylaxis and treatment of deep vein thrombosis (DVT) with or without pulmonary embolism (PE) in various settings, the prophylaxis of ischemic complications of unstable angina and non-Q-wave myocardial infarction (MI), and the treatment of acute ST-segment elevation MI managed medically or with subsequent percutaneous coronary intervention. The label for heparin14 includes includes similar prophylactic indications as well as the treatment of a broader spectrum of acute embolic events including peripheral arterial embolism and embolism in the setting of atrial fibrillation, the treatment of consumptive coagulopathies, and usage as an anticoagulant in high-risk patient groups such as those undergoing blood transfusions, extracorporeal circulation, and dialysis procedures. Furthermore, it is important to analyze whether these medications were administered as prophylactics or in treatment for a complication. Thus, it is possible that the patient population receiving heparin is more severely or acutely ill to begin with. In follow-up analyses, it may be interesting to consider initial laboratory values such as eGFR as a measure of baseline liver function as well. Nevertheless, accumulating evidence suggests that enoxaparin may be more efficacious than heparin in certain cases such as for the treatment of acute coronary syndromes...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1016/j.eclinm.2021.100774
  3. Version published to 10.1101/2020.10.06.20208025 on medRxiv