| Zdroj: |
Wong, A Y S, Tomlinson, L, Brown, J P, Elson, W, Walker, A J, Schultze, A, Morton, C E, Evans, D, Inglesby, P, MacKenna, B, Bhaskaran, K, Rentsch, C T, Powell, E, Williamson, E, Croker, R, Bacon, S, Hulme, W, Bates, C, Curtis, H J, Mehrkar, A, Cockburn, J, McDonald, H I, Mathur, R, Wing, K, Forbes, H, Eggo, R M, Evans, S J W, Smeeth, L, Goldacre, B & Douglas, I J 2022, ' Association between oral anticoagulants and COVID-19-related outcomes : a population-based cohort study ', British Journal of General Practice, vol. 72, no. 720, pp. E456-E463 . https://doi.org/10.3399/BJGP.2021.0689 |
| Popis: |
BackgroundEarly evidence has shown that anticoagulant reduces the risk of thrombotic events in those infected with COVID-19. However, evidence of the role of routinely prescribed oral anticoagulants (OACs) in COVID-19 outcomes is limited.AimTo investigate the association between OACs and COVID-19 outcomes in those with atrial fibrillation and a CHA2DS2-VASc score of 2.Design and settingOn behalf of NHS England, a population-based cohort study was conducted.MethodThe study used primary care data and pseudonymously-linked SARS-CoV-2 antigen testing data, hospital admissions, and death records from England. Cox regression was used to estimate hazard ratios (HRs) for COVID-19 outcomes comparing people with current OAC use versus non-use, accounting for age, sex, comorbidities, other medications, deprivation, and general practice.ResultsOf 71 103 people with atrial fibrillation and a CHA2DS2-VASc score of 2, there were 52 832 current OAC users and 18 271 non-users. No difference in risk of being tested for SARS-CoV-2 was associated with current use (adjusted HR [aHR] 0.99, 95% confidence interval [CI] = 0.95 to 1.04) versus non-use. A lower risk of testing positive for SARS-CoV-2 (aHR 0.77, 95% CI = 0.63 to 0.95) and a marginally lower risk of COVID-19-related death (aHR, 0.74, 95% CI = 0.53 to 1.04) were associated with current use versus non-use.ConclusionAmong those at low baseline stroke risk, people receiving OACs had a lower risk of testing positive for SARS-CoV-2 and severe COVID-19 outcomes than non-users; this might be explained by a causal effect of OACs in preventing severe COVID-19 outcomes or unmeasured confounding, including more cautious behaviours leading to reduced infection risk. |
