tetano
Editor, Senior Moderator
PLoS One
. 2022 Mar 24;17(3):e0265966.
doi: 10.1371/journal.pone.0265966. eCollection 2022.
Low versus high dose anticoagulation in patients with Coronavirus 2019 pneumonia at the time of admission to critical care units: A multicenter retrospective cohort study in the Beaumont healthcare system
Kadhim Al-Banaa[SUP] 1 [/SUP], Abbas Alshami[SUP] 2 [/SUP], Eiman Elhouderi[SUP] 3 [/SUP], Sally Hannoodee[SUP] 4 [/SUP], Maryam Hannoodee[SUP] 5 [/SUP], Alsadiq Al-Hillan[SUP] 6 [/SUP], Hussam Alhasson[SUP] 7 [/SUP], Faisal Musa[SUP] 1 [/SUP], Joseph Varon[SUP] 8 9 [/SUP], Sharon Einav[SUP] 10 11 [/SUP]
Affiliations
Abstract
Purpose: Coagulopathy is common in patients with COVID-19. The ideal approach to anticoagulation remains under debate. There is a significant variability in existing protocols for anticoagulation, and these are mostly based on sporadic reports, small studies, and expert opinion.
Materials and methods: This multicenter retrospective cohort study evaluated the association between anticoagulation dose and inpatient mortality among critically ill COVID-19 patients admitted to the intensive care units (ICUs) or step-down units (SDUs) of eight Beaumont Healthcare hospitals in Michigan, USA from March 10th to April 15th, 2020.
Results: Included were 578 patients with a median age of 64 years; among whom, 57.8% were males. Most patients (n = 447, 77.3%) received high dose and one in four (n = 131, 22.7%) received low dose anticoagulation. Overall mortality rate was 41.9% (n = 242). After adjusting for potential confounders (age, sex, race, BMI, ferritin level at hospital admission, intubation, comorbidities, mSOFA, and Padua score), administration of high anticoagulation doses at the time of ICU/SDU admission was associated with decreased inpatient mortality (OR 0.564, 95% CI 0.333-0.953, p = 0.032) compared to low dose.
Conclusion: Treatment with high dose anticoagulation at the time of ICU/SDU admission was associated with decreased adjusted mortality among critically ill adult patients with COVID-19.
. 2022 Mar 24;17(3):e0265966.
doi: 10.1371/journal.pone.0265966. eCollection 2022.
Low versus high dose anticoagulation in patients with Coronavirus 2019 pneumonia at the time of admission to critical care units: A multicenter retrospective cohort study in the Beaumont healthcare system
Kadhim Al-Banaa[SUP] 1 [/SUP], Abbas Alshami[SUP] 2 [/SUP], Eiman Elhouderi[SUP] 3 [/SUP], Sally Hannoodee[SUP] 4 [/SUP], Maryam Hannoodee[SUP] 5 [/SUP], Alsadiq Al-Hillan[SUP] 6 [/SUP], Hussam Alhasson[SUP] 7 [/SUP], Faisal Musa[SUP] 1 [/SUP], Joseph Varon[SUP] 8 9 [/SUP], Sharon Einav[SUP] 10 11 [/SUP]
Affiliations
- PMID: 35325001
- DOI: 10.1371/journal.pone.0265966
Abstract
Purpose: Coagulopathy is common in patients with COVID-19. The ideal approach to anticoagulation remains under debate. There is a significant variability in existing protocols for anticoagulation, and these are mostly based on sporadic reports, small studies, and expert opinion.
Materials and methods: This multicenter retrospective cohort study evaluated the association between anticoagulation dose and inpatient mortality among critically ill COVID-19 patients admitted to the intensive care units (ICUs) or step-down units (SDUs) of eight Beaumont Healthcare hospitals in Michigan, USA from March 10th to April 15th, 2020.
Results: Included were 578 patients with a median age of 64 years; among whom, 57.8% were males. Most patients (n = 447, 77.3%) received high dose and one in four (n = 131, 22.7%) received low dose anticoagulation. Overall mortality rate was 41.9% (n = 242). After adjusting for potential confounders (age, sex, race, BMI, ferritin level at hospital admission, intubation, comorbidities, mSOFA, and Padua score), administration of high anticoagulation doses at the time of ICU/SDU admission was associated with decreased inpatient mortality (OR 0.564, 95% CI 0.333-0.953, p = 0.032) compared to low dose.
Conclusion: Treatment with high dose anticoagulation at the time of ICU/SDU admission was associated with decreased adjusted mortality among critically ill adult patients with COVID-19.