biostudies-literatureNab LTrombosestichting NederlandZonMwthe Dutch Heart FoundationNetherlands Organization for Health Research and Development10321https://www.ebi.ac.uk/biostudies/studies/S-EPMC11937556biostudies-literatureUnknown15(1)Thrombotic complications are common in Coronavirus disease 2019 (COVID-19) patients, with pulmonary embolism (PE) being the most frequent. Randomised trials have provided inconclusive results on the optimal dosage of thromboprophylaxis in critically ill COVID-19 patients. We utilized data from the multicentre CAPACITY-COVID patient registry to assess the effect of differential application of Low Molecular Weight Heparin (LMWH) dose protocols on PE and in-hospital mortality risk in critically ill COVID-19 patients. An instrumental variable analysis was performed to estimate the intention-to-treat effect, utilizing differences in thromboprophylaxis prescribing behaviour between hospitals. We included 939 patients with PCR confirmed SARS-CoV-2 infection from 34 hospitals. Two-hundred-and-one Scientific reportsAssessing differential application of thromboprophylaxis regimes related to risk of pulmonary embolism and mortality in COVID-19 patients through instrumental variable analysis.PMC119375562020_A10430012010004project number 104300120100042020B006 CAPACITYKusadasi Nde Jonge EHackeng TMAsselbergs FWTen Cate-Hoek AJSchellings DAAMWilliams BKoopmans MPGHedayat BRokx CWestendorp PHMAlshehri AMAlmubarak YADouma RAMartens FMACAl-Ali AKStemerdink Avan de Watering DJvan de Beek DLeebeek FWGNoack DNierop PRRockx BHulshof AMde Vries JKHermanides RSVeneman Tvan den Akker JWinckers KHuisman MVHessels LMMagdelijns FJHAlnafie ANBemelmans RHHCornet AHovens MMCVlot EAvan Twist DJLVisser CHajer GRCroles FNBrouwer REPutter HRuiz RMvan Montfort PTieleman RGHugtenburg JGvan der Linden MMJMNinaber MKLangerak TWeytjens CLinschoten MPMvan der Heijden DJKruip MJHAKoning AMHZaal Rvan der Horst ICCFaber LMvan de Berg TWVlaar APJSiebelink HJden Uil CAvan Kesteren HAMReidinga ACSchurgers LJKempers EKTjong FVYOlie RHKlok FAMessiaen PKamphuisen PWGrootenboers MJJHPoorhosseini HSpaetgens BKroft LJMLijfering WMSchrover IMBos MHGommers DAMPJSmits PCvan Guldener Cde Jager CPCCoppens MKramers KRaadsen MPden Exter PLUrbanus RTvan Boxem AJMvan Veen HPAATuinman PRSaxena Mvan Gilst WHVink RDrost JTSchurink CAMTio RAVersteeg HHTong-Minh KWesterhof BDFerreira JBBruggeman RAGTen Berg JMRipley DPLeentjes Jvan Bussel BCTHenskens YMCSoei YLWolde MTMuller MCAVan Craenenbroeck EMFaber JMonraats PSRamai SRSvan Es NFranken BSondermeijer BMFaber HJKleijwegt FSStals MAMNossent EJKearney MTGeersing GJMiddeldorp SKrabbe JGMulder MMGHertogh CMPMKevenaar MERondon AMRRoest Tvan den Borst BCannegieter SCBruin SJuffermans NPSalah RDelsing CEStads SNab LMeijs DAMVerschure DOAujayeb AKietselaer BLJHWu KWMeijer KAl-Muhanna FASimons KSGroenemeijer BEKaasjager HAHFesten BHermans-van Ast JFDutch Covid and Thrombosis Coalition & the CAPACITY-COVID collaborative consortiumLansbergen ATimmermans PMeijs MFLTichelaar YIGMeijers JCMKaptein FHJEmans MEvan den Biggelaar MZaman AGvan Gorp ECMSaneei EMaas CStam FNieuwenhuizen LCaptur GHeunks LMAGeelhoed JJMKant MMontagna LNijziel MRSpronk HMHDorman HGREllerbroek JLJShafiee AKoster SCESchut AAntoni MLSchaap JWesterink JPrasad SWoudstra PGoeijenbier MTijmensen JEndeman HVliegen HWPinto YMde Jong CMMCaputo MGabriel LJewbali LSLaat BBurggraaf JLIvan den Toorn LMHeymans SRBMcCann GPMoriarty AWaal EGMEikenboom HCJvan Vlijmen BJMMosterd AKwakkel-van Erp JMBrouwer MCvan der Lee Ivan der Zee PMvan Smeden MSmulders YMvan Kooten Jvan Haaps TFKuiken TSmeets MJRLinssen GCMShore ACWils EJDe Sutter JSchutgens REGPaats MSBoersma WGWierda EBoutkourt FAnthonio RLvan der Meer POostdijk EANAlshahrani MCremer OLNijkeuter MDark PHunfeld NGMvan Ierssel SHTen Cate HRoukens AHEde Maat MPMvan Ofwegen-Hanekamp CEERibeiro MIABierings RVoorberg JHaerkens-Arends HEKopylov PYvan der Harst Pvan de Wal RMANoordegraaf AVde Haan LRWestendorp ICDLisman TLauw MNTessitore Ele Cessie SCharlotte NKuijper AFMHellou ERedon JAl-Windy NYYvan Hessen MWJBeishuizen APisters RfalseAssessing differential application of thromboprophylaxis regimes related to risk of pulmonary embolism and mortality in COVID-19 patients through instrumental variable analysis.Thrombotic complications are common in Coronavirus disease 2019 (COVID-19) patients, with pulmonary embolism (PE) being the most frequent. Randomised trials have provided inconclusive results on the optimal dosage of thromboprophylaxis in critically ill COVID-19 patients. We utilized data from the multicentre CAPACITY-COVID patient registry to assess the effect of differential application of Low Molecular Weight Heparin (LMWH) dose protocols on PE and in-hospital mortality risk in critically ill COVID-19 patients. An instrumental variable analysis was performed to estimate the intention-to-treat effect, utilizing differences in thromboprophylaxis prescribing behaviour between hospitals. We included 939 patients with PCR confirmed SARS-CoV-2 infection from 34 hospitals. Two-hundred-and-one 2025-01-01T00:00:00Z2025 Mar2025-07-02T03:04:53.238Z2025-07-02T03:04:53.238ZS-EPMC119375564013335510.1038/s41598-024-77858-w