Beneficial Effects of Anticoagulants on the Clinical Outcomes of COVID-19 Patients
(1) Background: Severe coronavirus disease can be complicated by a hypercoagulable state in conjunction with sepsis, increasing the risk of venous thromboembolism. This study aimed to observe the effect of anticoagulants on 30-day high-dependency unit (HDU) outcomes of moderate to severe coronavirus...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2021-11-01
|
| Series: | Antibiotics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2079-6382/10/11/1394 |
| _version_ | 1797511426874540032 |
|---|---|
| author | Zubia Jamil Azmat Ali Khan Samreen Khalid Muhammad Asghar Khalid Muhammad Yasir Waheed |
| author_facet | Zubia Jamil Azmat Ali Khan Samreen Khalid Muhammad Asghar Khalid Muhammad Yasir Waheed |
| author_sort | Zubia Jamil |
| collection | DOAJ |
| description | (1) Background: Severe coronavirus disease can be complicated by a hypercoagulable state in conjunction with sepsis, increasing the risk of venous thromboembolism. This study aimed to observe the effect of anticoagulants on 30-day high-dependency unit (HDU) outcomes of moderate to severe coronavirus disease 2019 (COVID-19) patients of a tertiary care hospital at Rawalpindi, Pakistan. (2) Methods: A retrospective propensity-based case–control study was carried out to examine COVID-19 patients admitted to the HDU. Patient groups who did and did not receive anticoagulants were labeled as “anticoagulant” and “non-anticoagulant”, respectively. Case–control matching (1:1) was performed via propensity scores (calculated by a regression model). Kaplan–Meier and logrank analyses were used to study survival probability. Single predictors of outcomes were determined by Cox regression analysis. (3) Results: The anticoagulant group had elevated D-dimers, advanced age, more comorbidities and a higher frequency of severe disease compared to the non-anticoagulant group (<i>p</i> < 0.05). Therefore, 47 cases and 47 matched controls were selected based on their propensity scores. The primary endpoint was outcome (survived vs. died). The 30-day in-HDU mortality was 25.5% for cases and 61.7% for controls (<i>p</i> = 0.0004). The median time from admission to death was 16 days for the case group and 7 days for the control group (<i>p</i> < 0.0001). The 30-day mortality was 19.1% for the enoxaparin group and 16.4% for the heparin group (<i>p</i> > 0.05). Enoxaparin (therapeutic and prophylactic doses) and heparin (prophylactic dose) were found to be independent factors affecting the outcomes of these patients (<i>p</i> < 0.001). (4) Conclusions: Anticoagulants play a beneficial role in reducing mortality among COVID-19 patients. Both anticoagulant formulations, enoxaparin (therapeutic and prophylactic doses) and heparin (prophylactic dose), were associated with improving survival among these patients. |
| first_indexed | 2024-03-10T05:45:06Z |
| format | Article |
| id | doaj.art-5aa55937f1ab42d8a8abdafe58387173 |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-10T05:45:06Z |
| publishDate | 2021-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-5aa55937f1ab42d8a8abdafe583871732023-11-22T22:11:00ZengMDPI AGAntibiotics2079-63822021-11-011011139410.3390/antibiotics10111394Beneficial Effects of Anticoagulants on the Clinical Outcomes of COVID-19 PatientsZubia Jamil0Azmat Ali Khan1Samreen Khalid2Muhammad Asghar3Khalid Muhammad4Yasir Waheed5Department of Medicine, Foundation University Medical College, Foundation University Islamabad, Islamabad 44000, PakistanPharmaceutical Biotechnology Laboratory, Department of Pharmaceutical Chemistry, College of Pharmacy, King Saud University, Riyadh 11451, Saudi ArabiaDepartment of Medicine, Foundation University Medical College, Foundation University Islamabad, Islamabad 44000, PakistanDivision of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet, 17177 Stockholm, SwedenDepartment of Biology, College of Sciences, United Arab Emirates University, Al Ain 15551, United Arab EmiratesMultidisciplinary Lab, Foundation University Medical College, Foundation University Islamabad, Islamabad 44000, Pakistan(1) Background: Severe coronavirus disease can be complicated by a hypercoagulable state in conjunction with sepsis, increasing the risk of venous thromboembolism. This study aimed to observe the effect of anticoagulants on 30-day high-dependency unit (HDU) outcomes of moderate to severe coronavirus disease 2019 (COVID-19) patients of a tertiary care hospital at Rawalpindi, Pakistan. (2) Methods: A retrospective propensity-based case–control study was carried out to examine COVID-19 patients admitted to the HDU. Patient groups who did and did not receive anticoagulants were labeled as “anticoagulant” and “non-anticoagulant”, respectively. Case–control matching (1:1) was performed via propensity scores (calculated by a regression model). Kaplan–Meier and logrank analyses were used to study survival probability. Single predictors of outcomes were determined by Cox regression analysis. (3) Results: The anticoagulant group had elevated D-dimers, advanced age, more comorbidities and a higher frequency of severe disease compared to the non-anticoagulant group (<i>p</i> < 0.05). Therefore, 47 cases and 47 matched controls were selected based on their propensity scores. The primary endpoint was outcome (survived vs. died). The 30-day in-HDU mortality was 25.5% for cases and 61.7% for controls (<i>p</i> = 0.0004). The median time from admission to death was 16 days for the case group and 7 days for the control group (<i>p</i> < 0.0001). The 30-day mortality was 19.1% for the enoxaparin group and 16.4% for the heparin group (<i>p</i> > 0.05). Enoxaparin (therapeutic and prophylactic doses) and heparin (prophylactic dose) were found to be independent factors affecting the outcomes of these patients (<i>p</i> < 0.001). (4) Conclusions: Anticoagulants play a beneficial role in reducing mortality among COVID-19 patients. Both anticoagulant formulations, enoxaparin (therapeutic and prophylactic doses) and heparin (prophylactic dose), were associated with improving survival among these patients.https://www.mdpi.com/2079-6382/10/11/1394COVID-19SARS-CoV-2heparinenoxaparinacute respiratory distress syndromepulmonary embolism |
| spellingShingle | Zubia Jamil Azmat Ali Khan Samreen Khalid Muhammad Asghar Khalid Muhammad Yasir Waheed Beneficial Effects of Anticoagulants on the Clinical Outcomes of COVID-19 Patients Antibiotics COVID-19 SARS-CoV-2 heparin enoxaparin acute respiratory distress syndrome pulmonary embolism |
| title | Beneficial Effects of Anticoagulants on the Clinical Outcomes of COVID-19 Patients |
| title_full | Beneficial Effects of Anticoagulants on the Clinical Outcomes of COVID-19 Patients |
| title_fullStr | Beneficial Effects of Anticoagulants on the Clinical Outcomes of COVID-19 Patients |
| title_full_unstemmed | Beneficial Effects of Anticoagulants on the Clinical Outcomes of COVID-19 Patients |
| title_short | Beneficial Effects of Anticoagulants on the Clinical Outcomes of COVID-19 Patients |
| title_sort | beneficial effects of anticoagulants on the clinical outcomes of covid 19 patients |
| topic | COVID-19 SARS-CoV-2 heparin enoxaparin acute respiratory distress syndrome pulmonary embolism |
| url | https://www.mdpi.com/2079-6382/10/11/1394 |
| work_keys_str_mv | AT zubiajamil beneficialeffectsofanticoagulantsontheclinicaloutcomesofcovid19patients AT azmatalikhan beneficialeffectsofanticoagulantsontheclinicaloutcomesofcovid19patients AT samreenkhalid beneficialeffectsofanticoagulantsontheclinicaloutcomesofcovid19patients AT muhammadasghar beneficialeffectsofanticoagulantsontheclinicaloutcomesofcovid19patients AT khalidmuhammad beneficialeffectsofanticoagulantsontheclinicaloutcomesofcovid19patients AT yasirwaheed beneficialeffectsofanticoagulantsontheclinicaloutcomesofcovid19patients |