Association between antithrombotic therapy and mortality in patients hospitalized for COVID‑19
Abstract Background The prothrombotic state is a common abnormality in patients with coronavirus disease 2019 (COVID-19). However, there is controversy over the use of anticoagulants, especially oral anticoagulants (OAC) due to limited studies. We sought to evaluate the association between antithrom...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-01-01
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| Series: | Thrombosis Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12959-023-00572-6 |
| _version_ | 1797362964421935104 |
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| author | Xing Wang Wuqian Chen Jiulin Guo Xingyu Qiu Chao You Lu Ma |
| author_facet | Xing Wang Wuqian Chen Jiulin Guo Xingyu Qiu Chao You Lu Ma |
| author_sort | Xing Wang |
| collection | DOAJ |
| description | Abstract Background The prothrombotic state is a common abnormality in patients with coronavirus disease 2019 (COVID-19). However, there is controversy over the use of anticoagulants, especially oral anticoagulants (OAC) due to limited studies. We sought to evaluate the association between antithrombotic therapy on mortality and clinical outcomes in patients hospitalized for COVID-19 through propensity score matching (PSM) analysis. Methods A retrospective cohort study was performed to include adult patients with COVID-19 in a university hospital. The primary outcome was in-hospital mortality. Secondary outcomes included intensive care unit (ICU) admission, mechanical ventilation, and acute kidney injury (AKI) during hospitalization. PSM was used as a powerful tool for matching patients’ baseline characteristics. Adjusted odds ratios (aOR) with 95% confidence intervals (CI) were calculated from the models. Results Of 4,881 COVID-19 patients during the study period, 690 (14.1%) patients received antithrombotic therapy and 4,191 (85.9%) patients were under no antithrombotic therapy. After adjustment with multivariate regression analysis, patients receiving OAC, compared with those who did not receive any antithrombotic therapy, had significantly lower odds for in-hospital mortality (aOR: 0.46. 95% CI: 0.24 to 0.87; P= 0.017). PSM analysis observed similar results (aOR: 0.35. 95% CI: 0.19 to 0.61; P< 0.001). Moreover, in critically ill patients who received mechanical ventilation, antithrombotic treatment (aOR: 0.54. 95% CI: 0.32 to 0.89; P= 0.022) was associated with reduced risk of mortality. Conclusions The application OACs was associated with reduced hospital mortality and mechanical ventilation requirement in COVID-19 patients. Besides, antithrombotic treatment was associated with a reduction in in-hospital mortality among critically ill COVID-19 patients who required mechanical ventilation. |
| first_indexed | 2024-03-08T16:14:13Z |
| format | Article |
| id | doaj.art-4c8797bd016848da9d8ff6dfec0b8392 |
| institution | Directory Open Access Journal |
| issn | 1477-9560 |
| language | English |
| last_indexed | 2024-03-08T16:14:13Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Thrombosis Journal |
| spelling | doaj.art-4c8797bd016848da9d8ff6dfec0b83922024-01-07T12:40:25ZengBMCThrombosis Journal1477-95602024-01-012211910.1186/s12959-023-00572-6Association between antithrombotic therapy and mortality in patients hospitalized for COVID‑19Xing Wang0Wuqian Chen1Jiulin Guo2Xingyu Qiu3Chao You4Lu Ma5Department of Neurosurgery, West China Hospital, Sichuan UniversityDepartment of Neurosurgery, West China Hospital, Sichuan UniversityInformation Center, West China Hospital, Sichuan UniversityDepartment of Neurosurgery, West China Hospital, Sichuan UniversityDepartment of Neurosurgery, West China Hospital, Sichuan UniversityDepartment of Neurosurgery, West China Hospital, Sichuan UniversityAbstract Background The prothrombotic state is a common abnormality in patients with coronavirus disease 2019 (COVID-19). However, there is controversy over the use of anticoagulants, especially oral anticoagulants (OAC) due to limited studies. We sought to evaluate the association between antithrombotic therapy on mortality and clinical outcomes in patients hospitalized for COVID-19 through propensity score matching (PSM) analysis. Methods A retrospective cohort study was performed to include adult patients with COVID-19 in a university hospital. The primary outcome was in-hospital mortality. Secondary outcomes included intensive care unit (ICU) admission, mechanical ventilation, and acute kidney injury (AKI) during hospitalization. PSM was used as a powerful tool for matching patients’ baseline characteristics. Adjusted odds ratios (aOR) with 95% confidence intervals (CI) were calculated from the models. Results Of 4,881 COVID-19 patients during the study period, 690 (14.1%) patients received antithrombotic therapy and 4,191 (85.9%) patients were under no antithrombotic therapy. After adjustment with multivariate regression analysis, patients receiving OAC, compared with those who did not receive any antithrombotic therapy, had significantly lower odds for in-hospital mortality (aOR: 0.46. 95% CI: 0.24 to 0.87; P= 0.017). PSM analysis observed similar results (aOR: 0.35. 95% CI: 0.19 to 0.61; P< 0.001). Moreover, in critically ill patients who received mechanical ventilation, antithrombotic treatment (aOR: 0.54. 95% CI: 0.32 to 0.89; P= 0.022) was associated with reduced risk of mortality. Conclusions The application OACs was associated with reduced hospital mortality and mechanical ventilation requirement in COVID-19 patients. Besides, antithrombotic treatment was associated with a reduction in in-hospital mortality among critically ill COVID-19 patients who required mechanical ventilation.https://doi.org/10.1186/s12959-023-00572-6AnticoagulantsCOVID- 19MortalityCritical IllnessAntiplatelet |
| spellingShingle | Xing Wang Wuqian Chen Jiulin Guo Xingyu Qiu Chao You Lu Ma Association between antithrombotic therapy and mortality in patients hospitalized for COVID‑19 Thrombosis Journal Anticoagulants COVID- 19 Mortality Critical Illness Antiplatelet |
| title | Association between antithrombotic therapy and mortality in patients hospitalized for COVID‑19 |
| title_full | Association between antithrombotic therapy and mortality in patients hospitalized for COVID‑19 |
| title_fullStr | Association between antithrombotic therapy and mortality in patients hospitalized for COVID‑19 |
| title_full_unstemmed | Association between antithrombotic therapy and mortality in patients hospitalized for COVID‑19 |
| title_short | Association between antithrombotic therapy and mortality in patients hospitalized for COVID‑19 |
| title_sort | association between antithrombotic therapy and mortality in patients hospitalized for covid 19 |
| topic | Anticoagulants COVID- 19 Mortality Critical Illness Antiplatelet |
| url | https://doi.org/10.1186/s12959-023-00572-6 |
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