tetano
Editor, Senior Moderator
J Thromb Thrombolysis
. 2021 Jun 1;1-5.
doi: 10.1007/s11239-021-02486-4. Online ahead of print.
Prior use of anticoagulation is associated with a better survival in COVID-19
A G Buenen[SUP] 1 2 [/SUP], Marijn Sinkeldam[SUP] 3 [/SUP], Martje L Maas[SUP] 4 [/SUP], Martha Verdonschot[SUP] 5 [/SUP], Peter C Wever[SUP] 6 [/SUP]
Affiliations
Abstract
Coronavirus disease 2019 (COVID-19) is associated with a high incidence of venous and arterial thromboembolic events. The role of anticoagulation (AC) prior to hospital admission and how different types of oral AC influences the outcome of COVID-19 is currently unknown. This observational study compares the outcome in COVID-19 patients with prior use of direct oral anticoagulants (DOAC) or vitamin K antagonists (VKA), and without prior use of AC. We collected the baseline characteristics and outcomes of COVID-19 patients presented to the emergency department of Bernhoven Hospital, the Netherlands. The primary outcome was all-cause mortality within 30 days and analyzed in a multivariable Cox proportional hazards model including age, sex, symptom duration, home medication, and comorbidities. We included 497 patients, including 57 patients with DOAC (11%) and 53 patients with VKA (11%). Patients with AC had a lower body temperature and lower C-reactive protein levels. Comparing the primary outcome in patients with AC (DOAC or VKA) and no AC, the adjusted hazard ratio (aHR) was 0.64 (95% CI 0.42-0.96, P = 0.03). Comparing DOAC and no AC, the aHR was 0.53 (95% CI 0.32-0.89, P = 0.02) and comparing VKA and no AC, the aHR was 0.77 (95% CI 0.47-1.27, P = 0.30). In a subgroup analysis of DOAC, all nine patients with prior use of dabigatran survived within 30 days. In this observational study, the prior use of AC is associated with a better survival of COVID-19. DOAC, especially dabigatran, might have additional beneficial effects.
Keywords: COVID-19; Direct oral anticoagulant; SARS-CoV-2; Thrombosis; Vitamin K antagonist.
. 2021 Jun 1;1-5.
doi: 10.1007/s11239-021-02486-4. Online ahead of print.
Prior use of anticoagulation is associated with a better survival in COVID-19
A G Buenen[SUP] 1 2 [/SUP], Marijn Sinkeldam[SUP] 3 [/SUP], Martje L Maas[SUP] 4 [/SUP], Martha Verdonschot[SUP] 5 [/SUP], Peter C Wever[SUP] 6 [/SUP]
Affiliations
- PMID: 34061283
- PMCID: PMC8166893
- DOI: 10.1007/s11239-021-02486-4
Abstract
Coronavirus disease 2019 (COVID-19) is associated with a high incidence of venous and arterial thromboembolic events. The role of anticoagulation (AC) prior to hospital admission and how different types of oral AC influences the outcome of COVID-19 is currently unknown. This observational study compares the outcome in COVID-19 patients with prior use of direct oral anticoagulants (DOAC) or vitamin K antagonists (VKA), and without prior use of AC. We collected the baseline characteristics and outcomes of COVID-19 patients presented to the emergency department of Bernhoven Hospital, the Netherlands. The primary outcome was all-cause mortality within 30 days and analyzed in a multivariable Cox proportional hazards model including age, sex, symptom duration, home medication, and comorbidities. We included 497 patients, including 57 patients with DOAC (11%) and 53 patients with VKA (11%). Patients with AC had a lower body temperature and lower C-reactive protein levels. Comparing the primary outcome in patients with AC (DOAC or VKA) and no AC, the adjusted hazard ratio (aHR) was 0.64 (95% CI 0.42-0.96, P = 0.03). Comparing DOAC and no AC, the aHR was 0.53 (95% CI 0.32-0.89, P = 0.02) and comparing VKA and no AC, the aHR was 0.77 (95% CI 0.47-1.27, P = 0.30). In a subgroup analysis of DOAC, all nine patients with prior use of dabigatran survived within 30 days. In this observational study, the prior use of AC is associated with a better survival of COVID-19. DOAC, especially dabigatran, might have additional beneficial effects.
Keywords: COVID-19; Direct oral anticoagulant; SARS-CoV-2; Thrombosis; Vitamin K antagonist.