RCT supports the use of therapeutic heparin in moderately ill patients admitted to the hospital with Covid-19.

Effectiveness of therapeutic heparin versus prophylactic heparin on death, mechanical ventilation, or intensive care unit admission in moderately ill patients with covid-19 admitted to hospital: RAPID randomised clinical trial – The BMJ

Commentary: High-dose of readily available blood thinner reduces risk of death for moderately ill COVID-19 patients – St. Michael’s Hospital

Related studies (some conflicting results)

RCT: Therapeutic-dose heparin superior to standard prophylactic or intermediate-dose heparins for thromboprophylaxis in high-risk hospitalized patients with COVID-19.

Another meta-analysis suggests standard-dose prophylactic anticoagulation is the best option for patients hospitalized with Covid-19.

M-A: Safety and efficacy of different prophylactic anticoagulation dosing regimens in critically and non-critically ill patients with COVID-19 – According to this analysis, standard-dose prophylactic anticoagulation should be the standard of care for hospitalized patients with COVID-19 who do not have an indication for therapeutic anticoagulation, irrespective of disease severity.

RCT: In noncritically ill patients hospitalized with Covid-19, therapeutic-dose anticoagulation with heparin increased the probability of survival to hospital discharge compared with usual-care thromboprophylaxis.

RCT: In critically ill patients with Covid-19, therapeutic anticoagulation with heparin did not result in improved outcomes compared to usual-care pharmacologic thromboprophylaxis.

RCT: In patients hospitalized with Covid-19 with elevated D-Dimer, a full-dose anticoagulation strategy based on rivaroxaban (full-dose heparins in unstable patients) + rivaroxaban to day 30 was not better than prophylactic anticoagulation and increased bleeding risk.

Commentary on Twitter

What are the effects of therapeutic heparin compared with prophylactic heparin among moderately ill patients with covid-19 admitted to hospital? #BMJResearch by @sholzberg and colleagues.

Includes a #VisualAbstract summarising the study #BMJInfographichttps://t.co/82VisuBKSU pic.twitter.com/b06TdIJvLX

— The BMJ (@bmj_latest) October 15, 2021