Objective: The findings from current studies comparing the feasibility and safety of anticoagulant dosages for non-ICU COVID-19 patients were inconsistent. We conducted the meta-analysis to examine the feasibility and safety of anticoagulants therapy versus no anticoagulants therapy.Methods: We searched PubMed, Web of Science, Embase, CINAHL, Cochrane Library, Ovid, ClinicalTrials.gov, and Google Scholar until July 15, 2021. The primary outcomes were thrombosis and any bleeding events. Secondary outcomes included pulmonary embolism, deep venous thrombosis, major bleeding, and invasive mechanical ventilation. Pooled risk ratios (RRs) and pooled incidence were reported. Results: 18,835 patients of 22 articles were selected in the systematic review and meta-analysis. The pooled incidence of any bleeding events and thrombosis were 3.4% and 9.3%. Compared with the group with no anticoagulants, the result showed that the group receiving anticoagulants was significantly associated with a 55% reduction in the risk of thrombosis(RR:0.45, 95% CI: 0.24-0.85; I2: 62.3%) but it was not significantly associated with the risk of bleeding events (RR:1.01,95% CI: 0.72-1.41; I2:23.3%). In addition, we found a lower risk of 29% in the group with prophylactic therapy (pooled RR:0.71, 95%CI: 0.57-0.88; I2:0%)in the invasive mechanical ventilation compared with no use group.Conclusions: Overall, prophylactic-dose anticoagulation was safe and feasible. We recommend it as the first consideration for non-ICU COVID-19 patients.Trial registration: The review protocol was registered in PROSPERO International Prospective Register of Systematic Reviews (CRD42021259911).

Lingqi Meng, Lingli Wu, Xuying Li. Different anticoagulant regimens for non-ICU COVID-19 patients:a systematic review and meta-analysis. Frontiers in Medical Science Research (2021) Vol. 3 Issue 6: 76-83. https://doi.org/10.25236/FMSR.2021.030614.

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