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.
<h4>Purpose</h4>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.&l...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2022-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0265966 |
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| author | Kadhim Al-Banaa Abbas Alshami Eiman Elhouderi Sally Hannoodee Maryam Hannoodee Alsadiq Al-Hillan Hussam Alhasson Faisal Musa Joseph Varon Sharon Einav |
| author_facet | Kadhim Al-Banaa Abbas Alshami Eiman Elhouderi Sally Hannoodee Maryam Hannoodee Alsadiq Al-Hillan Hussam Alhasson Faisal Musa Joseph Varon Sharon Einav |
| author_sort | Kadhim Al-Banaa |
| collection | DOAJ |
| description | <h4>Purpose</h4>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.<h4>Materials and methods</h4>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.<h4>Results</h4>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.<h4>Conclusion</h4>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. |
| first_indexed | 2024-04-13T16:30:08Z |
| format | Article |
| id | doaj.art-ff5c1310fc4048a8a78b406fcbcf0659 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-13T16:30:08Z |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-ff5c1310fc4048a8a78b406fcbcf06592022-12-22T02:39:36ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-01173e026596610.1371/journal.pone.0265966Low 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-BanaaAbbas AlshamiEiman ElhouderiSally HannoodeeMaryam HannoodeeAlsadiq Al-HillanHussam AlhassonFaisal MusaJoseph VaronSharon Einav<h4>Purpose</h4>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.<h4>Materials and methods</h4>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.<h4>Results</h4>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.<h4>Conclusion</h4>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.https://doi.org/10.1371/journal.pone.0265966 |
| spellingShingle | Kadhim Al-Banaa Abbas Alshami Eiman Elhouderi Sally Hannoodee Maryam Hannoodee Alsadiq Al-Hillan Hussam Alhasson Faisal Musa Joseph Varon Sharon Einav 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. PLoS ONE |
| title | 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. |
| title_full | 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. |
| title_fullStr | 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. |
| title_full_unstemmed | 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. |
| title_short | 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. |
| title_sort | 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 |
| url | https://doi.org/10.1371/journal.pone.0265966 |
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