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Background: Accumulating evidence has revealed that coagulopathy and widespread thrombosis in the lung are common in patients with Coronavirus Disease 2019 (COVID-19). This raises questions about the efficacy and safety of systemic anticoagulation (AC) in COVID-19 patients. Method: This single-center, retrospective, cohort study unselectively reviewed 2272 patients with COVID-19 admitted to the Tongji Hospital between Jan 25 and Mar 23, 2020. Propensity score-matching between patients adjusted for potential covariates was carried out with the patients divided into two groups depending on whether or not they had received AC treatment (AC group, ³7 days of treatment; non-AC group, no treatment). This yielded 164 patients in each group. Result: In-hospital mortality of the AC group was significantly lower than that of the non-AC group (14.0% vs. 28.7%, P =0.001). Treatment with AC was associated with a significantly lower probability of in-hospital death (adjusted HR=0.273, 95% CI, 0.154 to 0.484, PP=0.018), critical cases (20.0% vs 82.4%, P=0.003), patients with a D-dimer level ≥0.5 μg/mL (14.8% vs. 33.8, PP=0.003) or severe acute respiratory distress syndrome (ARDS) cases at admission (33.3% vs. 86.7%, P=0.004). During the hospital stay, critical cases (38.3% vs. 76.7%, PPConclusions: AC treatment decreases the risk of in-hospital mortality, especially in critically ill patients, with no additional significant, major bleeding events or thrombocytopenia being observed.Trials registration - ChiCTR2000039855 |
