Spyropoulos AC, Goldin M, Giannis D, et al. - The HEP-COVID multicenter randomized clinical trial was conducted to determine if therapeutic-dose low-molecular-weight heparin (LMWH), vs institutional standard prophylactic or intermediate-dose heparins, for thromboprophylaxis results in reduction in the incidence of major thromboembolism and death in high-risk hospitalized patients with COVID-19.

• A randomized clinical trial including 253 adults.

• With therapeutic-dose, the incidence of major thromboembolism or death was 28.7% relative to 41.9% with prophylactic/intermediate-dose heparins; a significant difference—driven by reduction in thromboembolism—that was not observed in critically ill patients.

• The groups did not show any significant difference in major bleeding.

• Overall findings revealed reduced occurrence of the composite outcome of major thromboembolism and death in high-risk inpatients with COVID-19 in correlation with thromboprophylaxis with therapeutic-dose low-molecular-weight heparin.