{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,12]],"date-time":"2026-07-12T05:07:44Z","timestamp":1783832864970,"version":"3.55.0"},"reference-count":46,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T00:00:00Z","timestamp":1754092800000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Medical Virology"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Severe COVID\u201019 is associated with increased prothrombotic and inflammatory responses, necessitating effective anticoagulation therapy. Novel oral anticoagulants (NOACs) are being explored as potential alternatives to low\u2010molecular\u2010weight heparin (LMWH). This retrospective observational cohort study compared the effectiveness and safety of NOACs and LMWH in reducing mortality among 76 critically ill, unvaccinated patients with confirmed SARS\u2010CoV\u20102 infection. The cohort included 41 patients treated with LMWH and 35 with NOACs during their ICU stay. The primary outcomes was mortality, while secondary outcomes included deep vein thrombosis (DVT), bleeding episodes, and transfusion rates. Baseline characteristics, including demographic data and severity scores, were similar between the groups (mean age: LMWH, 74.5\u2009\u00b1\u200915.1 years [59% male]; NOAC, 71.6\u2009\u00b1\u200914.8 years [60% male]). Mortality was significantly higher in the LMWH group (51.21% [95% confidence interval (CI): 36.4\u201365.7]) compared to the NOAC group (20% [95% CI: 10.0\u201335.9];\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.005), with standardized mortality ratios of 1.61 and 0.71, respectively (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.004). Elevated\n                    <jats:sc>d<\/jats:sc>\n                    \u2010dimer levels were strongly associated with an increased risk of mortality. Deep vein thrombosis (DVT) occurred in 9.76% of patients in the LMWH group and 5.71% of those in the NOAC group (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.68). Bleeding and transfusion rates were comparable between the groups. The use of NOACs was associated with a significantly lower mortality rate compared to LMWH in critically ill COVID\u201019 patients, reflecting an 81% reduction in the risk of death. These findings highlight the potential benefits of NOACs in the management of severe COVID\u201019 and underscore the need for further research to optimize anticoagulation strategies and improve patient outcomes.\n                  <\/jats:p>","DOI":"10.1002\/jmv.70535","type":"journal-article","created":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T14:14:27Z","timestamp":1754144067000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluating the Effectiveness of NOACs and LMWH in Reducing Mortality in Critically Ill Patients With COVID\u201019"],"prefix":"10.1002","volume":"97","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9725-3762","authenticated-orcid":false,"given":"Rubens Carmo","family":"Costa\u2010Filho","sequence":"first","affiliation":[{"name":"Laboratory of Immunopharmacology \u2013 IOC\/FIOCRUZ Rio de Janeiro RJ Brazil"},{"name":"Intensive Care Unit, Hospital Pr\u00f3\u2010Card\u00edaco, Rio 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Ferreira","family":"Costa","sequence":"additional","affiliation":[{"name":"Nephrology Department Hospital Pr\u00f3\u2010Card\u00edaco Rio de Janeiro RJ Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7652-0817","authenticated-orcid":false,"given":"Marcela Santos","family":"Azevedo","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina, Universidade Est\u00e1cio de S\u00e1, IDOMED Rio de Janeiro RJ Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5862-5256","authenticated-orcid":false,"given":"D\u00e9bora Fragoso","family":"Cerqueira","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina, Universidade Est\u00e1cio de S\u00e1, IDOMED Rio de Janeiro RJ Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2788-5223","authenticated-orcid":false,"given":"V\u00edctor Hugo Amaral","family":"Gualberto","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina, Universidade Est\u00e1cio de S\u00e1, IDOMED Rio de Janeiro RJ Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3758-4946","authenticated-orcid":false,"given":"Maria Izabel Neves de Holanda","family":"Barbosa","sequence":"additional","affiliation":[{"name":"Nephrology Department Hospital Pr\u00f3\u2010Card\u00edaco Rio de Janeiro RJ Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7455-2447","authenticated-orcid":false,"given":"Alda Maria","family":"Da\u2010Cruz","sequence":"additional","affiliation":[{"name":"Department of Parasitology\/DMIP Interdisciplinary Laboratory of Medical Research, IOC\/FIOCRUZ, Faculty of Medical Sciences, UERJ Rio de Janeiro RJ 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