Association of anticoagulation dose and survival in hospitalized COVID-19 patients : A retrospective propensity score-weighted analysis
© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd..
BACKGROUND: Hypercoagulability may contribute to COVID-19 pathogenicity. The role of anticoagulation (AC) at therapeutic (tAC) or prophylactic doses (pAC) is unclear.
OBJECTIVES: We evaluated the impact on survival of different AC doses in COVID-19 patients.
METHODS: Retrospective, multi-center cohort study of consecutive COVID-19 patients hospitalized between March 13 and May 5, 2020.
RESULTS: A total of 3480 patients were included (mean age, 64.5 years [17.0]; 51.5% female; 52.1% black and 40.6% white). 18.5% (n = 642) required intensive care unit (ICU) stay. 60.9% received pAC (n = 2121), 28.7% received ≥3 days of tAC (n = 998), and 10.4% (n = 361) received no AC. Propensity score (PS) weighted Kaplan-Meier plot demonstrated different 25-day survival probability in the tAC and pAC groups (57.5% vs 50.7%). In a PS-weighted multivariate proportional hazards model, AC was associated with reduced risk of death at prophylactic (hazard ratio [HR] 0.35 [95% confidence interval {CI} 0.22-0.54]) and therapeutic doses (HR 0.14 [95% CI 0.05-0.23]) compared to no AC. Major bleeding occurred more frequently in tAC patients (81 [8.1%]) compared to no AC (20 [5.5%]) or pAC (46 [2.2%]) subjects.
CONCLUSIONS: Higher doses of AC were associated with lower mortality in hospitalized COVID-19 patients. Prospective evaluation of efficacy and risk of AC in COVID-19 is warranted.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:106 |
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| Enthalten in: |
European journal of haematology - 106(2021), 2 vom: 11. Feb., Seite 165-174 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Ionescu, Filip [VerfasserIn] |
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| Links: |
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| Themen: |
Anticoagulants |
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| Anmerkungen: |
Date Completed 01.02.2021 Date Revised 07.12.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1111/ejh.13533 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM316133132 |
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| 100 | 1 | |a Ionescu, Filip |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Association of anticoagulation dose and survival in hospitalized COVID-19 patients |b A retrospective propensity score-weighted analysis |
| 264 | 1 | |c 2021 | |
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| 500 | |a Date Revised 07.12.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. | ||
| 520 | |a BACKGROUND: Hypercoagulability may contribute to COVID-19 pathogenicity. The role of anticoagulation (AC) at therapeutic (tAC) or prophylactic doses (pAC) is unclear | ||
| 520 | |a OBJECTIVES: We evaluated the impact on survival of different AC doses in COVID-19 patients | ||
| 520 | |a METHODS: Retrospective, multi-center cohort study of consecutive COVID-19 patients hospitalized between March 13 and May 5, 2020 | ||
| 520 | |a RESULTS: A total of 3480 patients were included (mean age, 64.5 years [17.0]; 51.5% female; 52.1% black and 40.6% white). 18.5% (n = 642) required intensive care unit (ICU) stay. 60.9% received pAC (n = 2121), 28.7% received ≥3 days of tAC (n = 998), and 10.4% (n = 361) received no AC. Propensity score (PS) weighted Kaplan-Meier plot demonstrated different 25-day survival probability in the tAC and pAC groups (57.5% vs 50.7%). In a PS-weighted multivariate proportional hazards model, AC was associated with reduced risk of death at prophylactic (hazard ratio [HR] 0.35 [95% confidence interval {CI} 0.22-0.54]) and therapeutic doses (HR 0.14 [95% CI 0.05-0.23]) compared to no AC. Major bleeding occurred more frequently in tAC patients (81 [8.1%]) compared to no AC (20 [5.5%]) or pAC (46 [2.2%]) subjects | ||
| 520 | |a CONCLUSIONS: Higher doses of AC were associated with lower mortality in hospitalized COVID-19 patients. Prospective evaluation of efficacy and risk of AC in COVID-19 is warranted | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a anticoagulation | |
| 650 | 4 | |a heparin | |
| 650 | 4 | |a novel coronavirus | |
| 650 | 7 | |a Anticoagulants |2 NLM | |
| 700 | 1 | |a Jaiyesimi, Ishmael |e verfasserin |4 aut | |
| 700 | 1 | |a Petrescu, Ioana |e verfasserin |4 aut | |
| 700 | 1 | |a Lawler, Patrick R |e verfasserin |4 aut | |
| 700 | 1 | |a Castillo, Edward |e verfasserin |4 aut | |
| 700 | 1 | |a Munoz-Maldonado, Yolanda |e verfasserin |4 aut | |
| 700 | 1 | |a Imam, Zaid |e verfasserin |4 aut | |
| 700 | 1 | |a Narasimhan, Mangala |e verfasserin |4 aut | |
| 700 | 1 | |a Abbas, Amr E |e verfasserin |4 aut | |
| 700 | 1 | |a Konde, Anish |e verfasserin |4 aut | |
| 700 | 1 | |a Nair, Girish B |e verfasserin |4 aut | |
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