Pre-medication with oral anticoagulants is associated with better outcomes in a large multinational COVID-19 cohort with cardiovascular comorbidities
Aims Coagulopathy and venous thromboembolism are common findings in coronavirus disease 2019 (COVID-19) and are associated with poor outcome. Timely initiation of anticoagulation after hospital admission was shown to be beneficial. In this study we aim to examine the association of pre-existing oral anticoagulation (OAC) with outcome among a cohort of SARS-CoV-2 infected patients. Methods and results We analysed the data from the large multi-national Lean European Open Survey on SARS-CoV-2 infected patients (LEOSS) from March to August 2020. Patients with SARS-CoV-2 infection were eligible for inclusion. We retrospectively analysed the association of pre-existing OAC with all-cause mortality. Secondary outcome measures included COVID-19-related mortality, recovery and composite endpoints combining death and/or thrombotic event and death and/or bleeding event. We restricted bleeding events to intracerebral bleeding in this analysis to ensure clinical relevance and to limit reporting errors. A total of 1 433 SARS-CoV-2 infected patients were analysed, while 334 patients (23.3%) had an existing premedication with OAC and 1 099 patients (79.7%) had no OAC. After risk adjustment for comorbidities, pre-existing OAC showed a protective influence on the endpoint death (OR 0.62, P = 0.013) as well as the secondary endpoints COVID-19-related death (OR 0.64, P = 0.023) and non-recovery (OR 0.66, P = 0.014). The combined endpoint death or thrombotic event tended to be less frequent in patients on OAC (OR 0.71, P = 0.056). Conclusions Pre-existing OAC is protective in COVID-19, irrespective of anticoagulation regime during hospital stay and independent of the stage and course of disease. Graphic abstract.
Medienart: |
Artikel |
---|
Erscheinungsjahr: |
2021 |
---|---|
Erschienen: |
2021 |
Enthalten in: |
Zur Gesamtaufnahme - volume:111 |
---|---|
Enthalten in: |
Clinical research in cardiology - 111(2021), 3 vom: 21. Sept., Seite 322-332 |
Sprache: |
Englisch |
---|
Beteiligte Personen: |
Rieder, Marina [VerfasserIn] |
---|
Links: |
Volltext [lizenzpflichtig] |
---|
BKL: | |
---|---|
Themen: |
RVK: |
---|
Anmerkungen: |
© The Author(s) 2021 |
---|
doi: |
10.1007/s00392-021-01939-3 |
---|
funding: |
|
---|---|
Förderinstitution / Projekttitel: |
|
PPN (Katalog-ID): |
OLC207812320X |
---|
LEADER | 01000caa a22002652 4500 | ||
---|---|---|---|
001 | OLC207812320X | ||
003 | DE-627 | ||
005 | 20230518112518.0 | ||
007 | tu | ||
008 | 221220s2021 xx ||||| 00| ||eng c | ||
024 | 7 | |a 10.1007/s00392-021-01939-3 |2 doi | |
035 | |a (DE-627)OLC207812320X | ||
035 | |a (DE-He213)s00392-021-01939-3-p | ||
040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
041 | |a eng | ||
082 | 0 | 4 | |a 610 |q VZ |
082 | 0 | 4 | |a 610 |q VZ |
084 | |a XA 37040 |q VZ |2 rvk | ||
084 | |a 44.85$jKardiologie$jAngiologie |2 bkl | ||
100 | 1 | |a Rieder, Marina |e verfasserin |4 aut | |
245 | 1 | 0 | |a Pre-medication with oral anticoagulants is associated with better outcomes in a large multinational COVID-19 cohort with cardiovascular comorbidities |
264 | 1 | |c 2021 | |
336 | |a Text |b txt |2 rdacontent | ||
337 | |a ohne Hilfsmittel zu benutzen |b n |2 rdamedia | ||
338 | |a Band |b nc |2 rdacarrier | ||
500 | |a © The Author(s) 2021 | ||
520 | |a Aims Coagulopathy and venous thromboembolism are common findings in coronavirus disease 2019 (COVID-19) and are associated with poor outcome. Timely initiation of anticoagulation after hospital admission was shown to be beneficial. In this study we aim to examine the association of pre-existing oral anticoagulation (OAC) with outcome among a cohort of SARS-CoV-2 infected patients. Methods and results We analysed the data from the large multi-national Lean European Open Survey on SARS-CoV-2 infected patients (LEOSS) from March to August 2020. Patients with SARS-CoV-2 infection were eligible for inclusion. We retrospectively analysed the association of pre-existing OAC with all-cause mortality. Secondary outcome measures included COVID-19-related mortality, recovery and composite endpoints combining death and/or thrombotic event and death and/or bleeding event. We restricted bleeding events to intracerebral bleeding in this analysis to ensure clinical relevance and to limit reporting errors. A total of 1 433 SARS-CoV-2 infected patients were analysed, while 334 patients (23.3%) had an existing premedication with OAC and 1 099 patients (79.7%) had no OAC. After risk adjustment for comorbidities, pre-existing OAC showed a protective influence on the endpoint death (OR 0.62, P = 0.013) as well as the secondary endpoints COVID-19-related death (OR 0.64, P = 0.023) and non-recovery (OR 0.66, P = 0.014). The combined endpoint death or thrombotic event tended to be less frequent in patients on OAC (OR 0.71, P = 0.056). Conclusions Pre-existing OAC is protective in COVID-19, irrespective of anticoagulation regime during hospital stay and independent of the stage and course of disease. Graphic abstract | ||
650 | 4 | |a COVID-19 | |
650 | 4 | |a Oral anticoagulation | |
650 | 4 | |a SARS-CoV-2 | |
650 | 4 | |a Thrombosis | |
700 | 1 | |a Gauchel, Nadine |0 (orcid)0000-0002-1276-9920 |4 aut | |
700 | 1 | |a Kaier, Klaus |4 aut | |
700 | 1 | |a Jakob, Carolin |4 aut | |
700 | 1 | |a Borgmann, Stefan |4 aut | |
700 | 1 | |a Classen, Annika Y. |4 aut | |
700 | 1 | |a Schneider, Jochen |4 aut | |
700 | 1 | |a Eberwein, Lukas |4 aut | |
700 | 1 | |a Lablans, Martin |4 aut | |
700 | 1 | |a Rüthrich, Maria |4 aut | |
700 | 1 | |a Dolff, Sebastian |4 aut | |
700 | 1 | |a Wille, Kai |4 aut | |
700 | 1 | |a Haselberger, Martina |4 aut | |
700 | 1 | |a Heuzeroth, Hanno |4 aut | |
700 | 1 | |a Bode, Christoph |4 aut | |
700 | 1 | |a von zur Mühlen, Constantin |4 aut | |
700 | 1 | |a Rieg, Siegbert |4 aut | |
700 | 1 | |a Duerschmied, Daniel |4 aut | |
773 | 0 | 8 | |i Enthalten in |t Clinical research in cardiology |d Springer Berlin Heidelberg, 2006 |g 111(2021), 3 vom: 21. Sept., Seite 322-332 |w (DE-627)504277812 |w (DE-600)2213295-8 |w (DE-576)252074890 |x 1861-0684 |7 nnns |
773 | 1 | 8 | |g volume:111 |g year:2021 |g number:3 |g day:21 |g month:09 |g pages:322-332 |
856 | 4 | 1 | |u https://doi.org/10.1007/s00392-021-01939-3 |z lizenzpflichtig |3 Volltext |
912 | |a GBV_USEFLAG_A | ||
912 | |a SYSFLAG_A | ||
912 | |a GBV_OLC | ||
912 | |a SSG-OLC-PHA | ||
912 | |a SSG-OLC-DE-84 | ||
912 | |a GBV_ILN_267 | ||
912 | |a GBV_ILN_2002 | ||
912 | |a GBV_ILN_2018 | ||
912 | |a GBV_ILN_2414 | ||
912 | |a GBV_ILN_4277 | ||
936 | r | v | |a XA 37040 |
936 | b | k | |a 44.85$jKardiologie$jAngiologie |q VZ |0 106409417 |0 (DE-625)106409417 |
951 | |a AR | ||
952 | |d 111 |j 2021 |e 3 |b 21 |c 09 |h 322-332 |