Does chronic oral anticoagulation reduce in-hospital mortality among COVID-19 older patients?

Autor: Covino M; Emergency Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.; Università Cattolica del Sacro Cuore, Roma, Italia., De Matteis G; Department of Internal Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. giuseppe.dematteis@policlinicogemelli.it., Della Polla D; Emergency Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy., Burzo ML; Emergency Department, Ospedale Generale M.G. Vannini, Istituto Figlie di San Camillo, Rome, Italy.; Ospedale Pediatrico Bambin Gesù IRCCS, Rome, Italy., Pascale MM; Emergency Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy., Santoro M; Emergency Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy., De Cristofaro R; Università Cattolica del Sacro Cuore, Roma, Italia.; Department of Medicine and Translational Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy., Gasbarrini A; Università Cattolica del Sacro Cuore, Roma, Italia.; Department of Internal Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy., De Candia E; Università Cattolica del Sacro Cuore, Roma, Italia.; Department of Medicine and Translational Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy., Franceschi F; Emergency Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.; Università Cattolica del Sacro Cuore, Roma, Italia.
Jazyk: angličtina
Zdroj: Aging clinical and experimental research [Aging Clin Exp Res] 2021 Aug; Vol. 33 (8), pp. 2335-2343. Date of Electronic Publication: 2021 Jul 03.
DOI: 10.1007/s40520-021-01924-w
Abstrakt: Background: Patients hospitalized with COVID-19 experienced an increased risk of venous thromboembolism.
Aims: To evaluate the effect of chronic oral anticoagulation (OAC) therapy, both with vitamin K antagonists (VKAs) or direct oral anticoagulants (DOACs), on prognosis of COVID-19 older patients.
Methods: Single-center prospective study conducted in the Emergency Department (ED) of a teaching hospital, referral center for COVID-19 in central Italy. We evaluated all the patients ≥ 65 years, consecutively admitted to our ED for confirmed COVID-19. We compared the clinical outcome of those who were on chronic OAC at ED admission with those who did not, using a propensity score matched paired cohort of controls. The primary study endpoint was all-cause in-hospital death. Patients were matched for age, sex, clinical comorbidities, and clinical severity at presentation (based on NEWS ≥ 6). Study parameters were assessed for association to all-cause in-hospital death by a multivariate Cox regression analysis to identify independent risk factor for survival.
Results: Although overall mortality was slightly higher for anticoagulated patients compared to controls (63.3% vs 43.5%, p = 0.012), the multivariate adjusted hazard ratio (HR) for death was not significant (HR = 1.56 [0.78-3.12]; p = 0.208). Both DOACs (HR 1.46 [0.73-2.92]; p = 0.283) and VKAs (HR 1.14 [0.48-2.73]; p = 0.761) alone did not affect overall survival in our cohort.
Conclusions: Among older patients hospitalized for COVID-19, chronic OAC therapy was not associated with a reduced risk of in-hospital death. Moreover, our data suggest similar outcome both for patients on VKAs or in patients on DOACs.
(© 2021. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)
Databáze: MEDLINE
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