tetano
Editor, Senior Moderator
Int J Infect Dis
. 2021 Sep 10;S1201-9712(21)00725-6.
doi: 10.1016/j.ijid.2021.09.014. Online ahead of print.
Evaluation of the efficacy of anticoagulation therapy in reducing mortality in a nationwide cohort of hospitalized patients with coronavirus disease in Japan
Hisao Hara[SUP] 1 [/SUP], Yukari Uemura[SUP] 2 [/SUP], Kayoko Hayakawa[SUP] 3 [/SUP], Tomiteru Togano[SUP] 4 [/SUP], Yusuke Asai[SUP] 5 [/SUP], Nobuaki Matsunaga[SUP] 5 [/SUP], Mari Terada[SUP] 6 [/SUP], Hiroshi Ohtsu[SUP] 2 [/SUP], Koji Kitajima[SUP] 2 [/SUP], Yousuke Shimizu[SUP] 2 [/SUP], Lubna Sato[SUP] 7 [/SUP], Masahiro Ishikane[SUP] 3 [/SUP], Noriko Kinoshita-Iwamoto[SUP] 3 [/SUP], Taro Shibata[SUP] 8 [/SUP], Masashi Kondo[SUP] 9 [/SUP], Kazuo Izumi[SUP] 2 [/SUP], Wataru Sugiura[SUP] 8 [/SUP], Norio Ohmagari[SUP] 10 [/SUP]
Affiliations
Abstract
Objectives: To determine whether anticoagulation therapy improves outcomes in patients with coronavirus disease (COVID-19) in Japan given their lower risk of thrombosis compared with Western cohorts.
Methods: The efficacy of anticoagulation therapy in hospitalized COVID-19 patients was evaluated using a nationwide registry, the COVID-19 Registry Japan. Inverse probability of weight treatment method was used to adjust for baseline confounders in the anticoagulation and non-anticoagulation groups.
Results: Of the 1748 patients included, anticoagulants were used in 367 patients (treatment group). The patients in the anticoagulant group were older and predominantly male and often presented with obesity, hyperlipidemia, hypertension, diabetes, and elevated D-dimer levels. The 29-day mortality was 7.6% in the whole cohort (treatment group, 11.2%; no treatment group, 6.6%), 6% in patients who were not treated with steroids (treatment group, 12.3%; no treatment group, 5.2%), and 11.2% in patients treated with steroids (treatment group, 10.5%; no treatment group, 11.8%). Mortality in the whole cohort was similar between the treatment and no treatment groups (p=0.99), and an insignificant decreasing trend in mortality was observed in those treated with steroids (p=0.075).
Conclusions: Anticoagulants may be beneficial in Asians whose comorbidity and thrombosis risk may differ from those of other ethnic groups.
Keywords: Anticoagulant therapy; Asia; coronavirus disease; steroids; thrombosis.
. 2021 Sep 10;S1201-9712(21)00725-6.
doi: 10.1016/j.ijid.2021.09.014. Online ahead of print.
Evaluation of the efficacy of anticoagulation therapy in reducing mortality in a nationwide cohort of hospitalized patients with coronavirus disease in Japan
Hisao Hara[SUP] 1 [/SUP], Yukari Uemura[SUP] 2 [/SUP], Kayoko Hayakawa[SUP] 3 [/SUP], Tomiteru Togano[SUP] 4 [/SUP], Yusuke Asai[SUP] 5 [/SUP], Nobuaki Matsunaga[SUP] 5 [/SUP], Mari Terada[SUP] 6 [/SUP], Hiroshi Ohtsu[SUP] 2 [/SUP], Koji Kitajima[SUP] 2 [/SUP], Yousuke Shimizu[SUP] 2 [/SUP], Lubna Sato[SUP] 7 [/SUP], Masahiro Ishikane[SUP] 3 [/SUP], Noriko Kinoshita-Iwamoto[SUP] 3 [/SUP], Taro Shibata[SUP] 8 [/SUP], Masashi Kondo[SUP] 9 [/SUP], Kazuo Izumi[SUP] 2 [/SUP], Wataru Sugiura[SUP] 8 [/SUP], Norio Ohmagari[SUP] 10 [/SUP]
Affiliations
- PMID: 34517044
- DOI: 10.1016/j.ijid.2021.09.014
Abstract
Objectives: To determine whether anticoagulation therapy improves outcomes in patients with coronavirus disease (COVID-19) in Japan given their lower risk of thrombosis compared with Western cohorts.
Methods: The efficacy of anticoagulation therapy in hospitalized COVID-19 patients was evaluated using a nationwide registry, the COVID-19 Registry Japan. Inverse probability of weight treatment method was used to adjust for baseline confounders in the anticoagulation and non-anticoagulation groups.
Results: Of the 1748 patients included, anticoagulants were used in 367 patients (treatment group). The patients in the anticoagulant group were older and predominantly male and often presented with obesity, hyperlipidemia, hypertension, diabetes, and elevated D-dimer levels. The 29-day mortality was 7.6% in the whole cohort (treatment group, 11.2%; no treatment group, 6.6%), 6% in patients who were not treated with steroids (treatment group, 12.3%; no treatment group, 5.2%), and 11.2% in patients treated with steroids (treatment group, 10.5%; no treatment group, 11.8%). Mortality in the whole cohort was similar between the treatment and no treatment groups (p=0.99), and an insignificant decreasing trend in mortality was observed in those treated with steroids (p=0.075).
Conclusions: Anticoagulants may be beneficial in Asians whose comorbidity and thrombosis risk may differ from those of other ethnic groups.
Keywords: Anticoagulant therapy; Asia; coronavirus disease; steroids; thrombosis.