tetano
Editor, Senior Moderator
Clin Appl Thromb Hemost
. Jan-Dec 2021;27:10760296211008999.
doi: 10.1177/10760296211008999.
Anticoagulation and In-Hospital Mortality From Coronavirus Disease 2019: A Systematic Review and Meta-Analysis
Chatphatai Moonla[SUP] 1 2 [/SUP], Darintr Sosothikul[SUP] 3 4 [/SUP], Thita Chiasakul[SUP] 1 2 [/SUP], Ponlapat Rojnuckarin[SUP] 1 2 [/SUP], Noppacharn Uaprasert[SUP] 1 2 [/SUP]
Affiliations
Abstract
Hypercoagulability in coronavirus disease 2019 (COVID-19) may aggravate disease severity during hospitalization but the reported survival benefits from anticoagulation (AC) vary among studies. We performed a literature research to estimate pooled odds ratios (ORs) of in-hospital mortality and major bleeding comparing among intermediate-to-therapeutic dose AC, prophylactic dose AC, and no AC. Until October 22, 2020, PubMed, EMBASE, and Cochrane Library Database were searched for studies reporting AC utilization and mortality in COVID-19. Studies with suspected risk of bias were excluded before the synthesis of pooled ORs with 95% confidence intervals (CIs) using random-effects models. Of 37 identified studies (N = 19,510), 17 (N = 17,833) were aggregated in the meta-analysis. The overall mortality rate was 23.1% (95% CI 18.7-28.2). The pooled odds of mortality comparing anticoagulated to non-anticoagulated patients were similar, but lower in prophylactic dose AC group (OR 0.83; 95% CI 0.73-0.95). Notably, intermediate-to-therapeutic dose AC increased mortality (OR 1.60; 95% CI 1.11-2.31) and major bleeding compared to prophylactic dose AC (OR 3.33; 95% CI 2.34-4.72). Our findings support the optimal efficacy and safety profiles of prophylactic dose AC in hospitalized COVID-19 patients.
Keywords: COVID-19; SARS-CoV-2; anticoagulation; meta-analysis; mortality.
. Jan-Dec 2021;27:10760296211008999.
doi: 10.1177/10760296211008999.
Anticoagulation and In-Hospital Mortality From Coronavirus Disease 2019: A Systematic Review and Meta-Analysis
Chatphatai Moonla[SUP] 1 2 [/SUP], Darintr Sosothikul[SUP] 3 4 [/SUP], Thita Chiasakul[SUP] 1 2 [/SUP], Ponlapat Rojnuckarin[SUP] 1 2 [/SUP], Noppacharn Uaprasert[SUP] 1 2 [/SUP]
Affiliations
- PMID: 33874753
- DOI: 10.1177/10760296211008999
Abstract
Hypercoagulability in coronavirus disease 2019 (COVID-19) may aggravate disease severity during hospitalization but the reported survival benefits from anticoagulation (AC) vary among studies. We performed a literature research to estimate pooled odds ratios (ORs) of in-hospital mortality and major bleeding comparing among intermediate-to-therapeutic dose AC, prophylactic dose AC, and no AC. Until October 22, 2020, PubMed, EMBASE, and Cochrane Library Database were searched for studies reporting AC utilization and mortality in COVID-19. Studies with suspected risk of bias were excluded before the synthesis of pooled ORs with 95% confidence intervals (CIs) using random-effects models. Of 37 identified studies (N = 19,510), 17 (N = 17,833) were aggregated in the meta-analysis. The overall mortality rate was 23.1% (95% CI 18.7-28.2). The pooled odds of mortality comparing anticoagulated to non-anticoagulated patients were similar, but lower in prophylactic dose AC group (OR 0.83; 95% CI 0.73-0.95). Notably, intermediate-to-therapeutic dose AC increased mortality (OR 1.60; 95% CI 1.11-2.31) and major bleeding compared to prophylactic dose AC (OR 3.33; 95% CI 2.34-4.72). Our findings support the optimal efficacy and safety profiles of prophylactic dose AC in hospitalized COVID-19 patients.
Keywords: COVID-19; SARS-CoV-2; anticoagulation; meta-analysis; mortality.