Evaluation of the efficacy of anticoagulation therapy in reducing mortality in a nationwide cohort of hospitalized patients with coronavirus disease in Japan
ABSTRACT: Objectives: To determine whether anticoagulation therapy improves outcomes in patients with coronavirus disease 2019 (COVID-19) in Japan given their lower risk of thrombosis compared with Western cohorts. Methods: The efficacy of anticoagulation therapy in hospitalized patients with COVID...
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| Format: | Article |
| Language: | English |
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Elsevier
2021-11-01
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| Series: | International Journal of Infectious Diseases |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971221007256 |
| _version_ | 1829490120659566592 |
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| author | Hisao Hara Yukari Uemura Kayoko Hayakawa Tomiteru Togano Yusuke Asai Nobuaki Matsunaga Mari Terada Hiroshi Ohtsu Koji Kitajima Yousuke Shimizu Lubna Sato Masahiro Ishikane Noriko Kinoshita-Iwamoto Taro Shibata Masashi Kondo Kazuo Izumi Wataru Sugiura Norio Ohmagari |
| author_facet | Hisao Hara Yukari Uemura Kayoko Hayakawa Tomiteru Togano Yusuke Asai Nobuaki Matsunaga Mari Terada Hiroshi Ohtsu Koji Kitajima Yousuke Shimizu Lubna Sato Masahiro Ishikane Noriko Kinoshita-Iwamoto Taro Shibata Masashi Kondo Kazuo Izumi Wataru Sugiura Norio Ohmagari |
| author_sort | Hisao Hara |
| collection | DOAJ |
| description | ABSTRACT: Objectives: To determine whether anticoagulation therapy improves outcomes in patients with coronavirus disease 2019 (COVID-19) in Japan given their lower risk of thrombosis compared with Western cohorts. Methods: The efficacy of anticoagulation therapy in hospitalized patients with COVID-19 was evaluated using a nationwide registry: the COVID-19 Registry Japan. The 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, predominantly male, and often presented with obesity, hyperlipidaemia, hypertension, diabetes and elevated D-dimer levels. Twenty-nine-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 patients treated with steroids (P=0.075). Conclusions: Anticoagulants may be beneficial in Asians, in whom comorbidities and risk of thrombosis may differ from other ethnic groups. |
| first_indexed | 2024-12-15T00:19:01Z |
| format | Article |
| id | doaj.art-56635adb88f74ddba7590f276c56ce8b |
| institution | Directory Open Access Journal |
| issn | 1201-9712 |
| language | English |
| last_indexed | 2024-12-15T00:19:01Z |
| publishDate | 2021-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj.art-56635adb88f74ddba7590f276c56ce8b2022-12-21T22:42:22ZengElsevierInternational Journal of Infectious Diseases1201-97122021-11-01112111116Evaluation of the efficacy of anticoagulation therapy in reducing mortality in a nationwide cohort of hospitalized patients with coronavirus disease in JapanHisao Hara0Yukari Uemura1Kayoko Hayakawa2Tomiteru Togano3Yusuke Asai4Nobuaki Matsunaga5Mari Terada6Hiroshi Ohtsu7Koji Kitajima8Yousuke Shimizu9Lubna Sato10Masahiro Ishikane11Noriko Kinoshita-Iwamoto12Taro Shibata13Masashi Kondo14Kazuo Izumi15Wataru Sugiura16Norio Ohmagari17Department of Cardiology, National Centre for Global Health and Medicine, Tokyo, Japan; Corresponding author. Department of Cardiology, National Centre for Global Health and Medicine, 1-12-1 Toyama Shinjuku-ku, Tokyo 162-8655, Japan. Tel.: +81 3 3202 7181; fax: +81 3 3202 7364.Biostatistics Section, Centre for Clinical Sciences, National Centre for Global Health and Medicine, Tokyo, JapanDisease Control and Prevention Centre, National Centre for Global Health and Medicine, Tokyo, Japan; AMR Clinical Reference Centre, National Centre for Global Health and Medicine, Tokyo, JapanDepartment of Haematology, National Centre for Global Health and Medicine, Tokyo, JapanAMR Clinical Reference Centre, National Centre for Global Health and Medicine, Tokyo, JapanAMR Clinical Reference Centre, National Centre for Global Health and Medicine, Tokyo, JapanBiostatistics Section, Centre for Clinical Sciences, National Centre for Global Health and Medicine, Tokyo, Japan; Disease Control and Prevention Centre, National Centre for Global Health and Medicine, Tokyo, JapanBiostatistics Section, Centre for Clinical Sciences, National Centre for Global Health and Medicine, Tokyo, JapanBiostatistics Section, Centre for Clinical Sciences, National Centre for Global Health and Medicine, Tokyo, JapanBiostatistics Section, Centre for Clinical Sciences, National Centre for Global Health and Medicine, Tokyo, JapanDisease Control and Prevention Centre, National Centre for Global Health and Medicine, Tokyo, JapanDisease Control and Prevention Centre, National Centre for Global Health and Medicine, Tokyo, Japan; AMR Clinical Reference Centre, National Centre for Global Health and Medicine, Tokyo, JapanDisease Control and Prevention Centre, National Centre for Global Health and Medicine, Tokyo, Japan; AMR Clinical Reference Centre, National Centre for Global Health and Medicine, Tokyo, JapanBiostatistics Division, Centre for Research Administration and Support, National Cancer Centre, Tokyo, JapanCentre for Clinical Trial and Research Support, Fujita Health University, Aichi, JapanBiostatistics Section, Centre for Clinical Sciences, National Centre for Global Health and Medicine, Tokyo, JapanBiostatistics Division, Centre for Research Administration and Support, National Cancer Centre, Tokyo, JapanDepartment of Haematology, National Centre for Global Health and Medicine, Tokyo, Japan; Biostatistics Division, Centre for Research Administration and Support, National Cancer Centre, Tokyo, JapanABSTRACT: Objectives: To determine whether anticoagulation therapy improves outcomes in patients with coronavirus disease 2019 (COVID-19) in Japan given their lower risk of thrombosis compared with Western cohorts. Methods: The efficacy of anticoagulation therapy in hospitalized patients with COVID-19 was evaluated using a nationwide registry: the COVID-19 Registry Japan. The 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, predominantly male, and often presented with obesity, hyperlipidaemia, hypertension, diabetes and elevated D-dimer levels. Twenty-nine-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 patients treated with steroids (P=0.075). Conclusions: Anticoagulants may be beneficial in Asians, in whom comorbidities and risk of thrombosis may differ from other ethnic groups.http://www.sciencedirect.com/science/article/pii/S1201971221007256Anticoagulant therapySteroidsCoronavirus diseaseThrombosisAsia |
| spellingShingle | Hisao Hara Yukari Uemura Kayoko Hayakawa Tomiteru Togano Yusuke Asai Nobuaki Matsunaga Mari Terada Hiroshi Ohtsu Koji Kitajima Yousuke Shimizu Lubna Sato Masahiro Ishikane Noriko Kinoshita-Iwamoto Taro Shibata Masashi Kondo Kazuo Izumi Wataru Sugiura Norio Ohmagari Evaluation of the efficacy of anticoagulation therapy in reducing mortality in a nationwide cohort of hospitalized patients with coronavirus disease in Japan International Journal of Infectious Diseases Anticoagulant therapy Steroids Coronavirus disease Thrombosis Asia |
| title | Evaluation of the efficacy of anticoagulation therapy in reducing mortality in a nationwide cohort of hospitalized patients with coronavirus disease in Japan |
| title_full | Evaluation of the efficacy of anticoagulation therapy in reducing mortality in a nationwide cohort of hospitalized patients with coronavirus disease in Japan |
| title_fullStr | Evaluation of the efficacy of anticoagulation therapy in reducing mortality in a nationwide cohort of hospitalized patients with coronavirus disease in Japan |
| title_full_unstemmed | Evaluation of the efficacy of anticoagulation therapy in reducing mortality in a nationwide cohort of hospitalized patients with coronavirus disease in Japan |
| title_short | Evaluation of the efficacy of anticoagulation therapy in reducing mortality in a nationwide cohort of hospitalized patients with coronavirus disease in Japan |
| title_sort | evaluation of the efficacy of anticoagulation therapy in reducing mortality in a nationwide cohort of hospitalized patients with coronavirus disease in japan |
| topic | Anticoagulant therapy Steroids Coronavirus disease Thrombosis Asia |
| url | http://www.sciencedirect.com/science/article/pii/S1201971221007256 |
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