A Multicenter Randomized Clinical Trial of Modulation of Host Thromboinflammatory Response in Hospitalized Patients with COVID-19: The DAWn-Antico Study

Matthias M. Engelen, M.D.
University Hospitals Leuven
Leuven, Belgium

Thromboinflammation in severe COVID-19 is associated with disease severity and outcome. The kallikrein pathway is suggested to mediate thromboinflammation in COVID-19 by activating inflammatory pathways and contact-mediated coagulation. Matthias M. Engelen, M.D., discusses how the multicenter, randomized DAWn-Antico study, lead by Dr. Thomas Vanassche, investigated whether multitarget modulation of this thromboinflammatory response improves outcomes in hospitalized COVID-19 patients. Patients in the intervention group received kallikrein-inhibiting aprotinin combined with intensified Low Molecular Weight Heparin. Anakinra was added in case of predefined hyperinflammation. The primary outcome was time-sustained clinical improvement or hospital discharge. Secondary outcomes included clinical and biochemical parameters.

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