Rivaroxiban effective in treating COVID 19 patients: MICHELLE Trial

The covid pandemic has rained its havoc in the entire world.  Millions of patients died and many more were discharged worldwide. Excessive thrombosis was the designated culprit for the morbidity and mortality. MICELLE trial was conducted to find out whether rivaroxiban which is a direct anticoagulant is useful in patients after hospitalization for covid-19 for improving their clinical outcomes without bleeding. This was a landmark trial.

 The primary outcome reported symptomatic venous thromboembolism, venous thromboembolism-related death, bilateral venous thromboembolism, symptomatic arterial thromboembolism, myocardial infarction, non hemorrhagic stroke, major adverse limb event, or cardiovascular death at 35 days, was 3.14% in the rivaroxaban group compared with 9.43% in the control group. Among patients discharged after COVID-19 infection, rivaroxaban for 35 days was beneficial.

The trials main purpose was to evaluate rivaroxaban compared with control among patients discharged after hospitalization for coronavirus disease infection. Over 160 participants discharged after COVID-19 infection were randomized to rivaroxaban 10 mg daily, vs control. Rivaroxaban was associated with a reduction in clinical events without increasing major bleeding.