Is thromboprophylaxis with high-dose enoxaparin really necessary for COVID-19 patients? A new “prudent” randomised clinical trial

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Dear Sir,
We enjoyed reading the position paper by the Italian Society on Thrombosis and Haemostasis (SISET) that was recently published in Blood Transfusion1. It stands out as a rational and well-balanced document in a time of often confused and emotionally-charged initiatives in the management of COVID-19, a severe disease about which still not enough is known2. We would like to focus our attention on the recommendation to urgently organise randomised clinical trials (RCT), hopefully supported by the Italian drug agency (AIFA), comparing standard low-dose unfractionated or low molecular weight heparin (LMWH) with higher doses for thromboprophylaxis of COVID-19 patients, who are apparently at very high risk for venous thromboembolism (VTE). [ … ]