Mortality and the Use of Antithrombotic Therapies Among Nursing Home Residents withCOVID-19

Autor: Ron Heijnen, Jos M. G. A. Schols, Fabienne J. H. Magdelijns, Renée A. G. Brüggemann, Aimée E. M. J. H. Linkens, Hanneke Joosten, Arina J. ten Cate-Hoek, Bart Spaetgens, Steffie H. A. Brouns, Hugo ten Cate
Přispěvatelé: Biochemie, MUMC+: MA Med Staf Artsass Interne Geneeskunde (9), RS: CAPHRI - R1 - Ageing and Long-Term Care, MUMC+: MA Alg Interne Geneeskunde (9), MUMC+: MA Medische Staf IC (9), Health Services Research, RS: Academische Werkplaats Ouderenzorg, Interne Geneeskunde, MUMC+: HVC Trombosezorg (8), MUMC+: HVC Pieken Trombose (9), RS: Carim - B04 Clinical thrombosis and Haemostasis, RS: CAPHRI - R3 - Functioning, Participating and Rehabilitation
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Male
030204 cardiovascular system & hematology
thromboembolic complications
Logistic regression
older people
0302 clinical medicine
Antithrombotic
Odds Ratio
Homes for the Aged
030212 general & internal medicine
Netherlands
Aged
80 and over
education.field_of_study
COMPLICATIONS
Incidence (epidemiology)
Incidence
nursing home
Female
Coronavirus Infections
medicine.medical_specialty
Population
Pneumonia
Viral
Clinical Investigations
03 medical and health sciences
Betacoronavirus
Sex Factors
Fibrinolytic Agents
COVID‐19
Internal medicine
Thromboembolism
medicine
Humans
Clinical Investigation
education
Pandemics
Aged
Retrospective Studies
business.industry
SARS-CoV-2
COVID-19
Retrospective cohort study
Odds ratio
medicine.disease
Comorbidity
mortality
Confidence interval
Nursing Homes
COVID-19 Drug Treatment
Geriatrics and Gerontology
business
Zdroj: Journal of the American Geriatrics Society
Journal of the American Geriatrics Society, 68(8), 1647-1652. Wiley
ISSN: 0002-8614
1647-1652
DOI: 10.1111/jgs.16664
Popis: BACKGROUND/OBJECTIVES: Nursing home (NH) residents are a vulnerable population, susceptible to respiratory disease outbreaks such as coronavirus disease 2019 (COVID-19). Poor outcome in COVID-19 is at least partly attributed to hypercoagulability, resulting in a high incidence of thromboembolic complications. It is unknown whether commonly used antithrombotic therapies may protect the vulnerable NH population with COVID-19 against mortality. This study aimed to investigate whether the use of oral antithrombotic therapy (OAT) was associated with a lower mortality in NH residents with COVID-19. DESIGN: A retrospective case series. SETTING: Fourteen NH facilities from the NH organization Envida, Maastricht, the Netherlands PARTICIPANTS: A total of 101 NH residents with COVID-19 were enrolled. MEASUREMENTS: The primary outcome was all-cause mortality. The association between age, sex, comorbidity, OAT, and mortality was assessed using logistic regression analysis. RESULTS: Overall mortality was 47.5% in NH residents from 14 NH facilities. Age, comorbidity, and medication use were comparable among NH residents who survived and who died. OAT was associated with a lower mortality in NH residents with COVID-19 in the univariable analysis (odds ratio (OR) = 0.89; 95% confidence interval (CI) = 0.41-1.95). However, additional adjustments for sex, age, and comorbidity attenuated this difference. Mortality in males was higher compared with female residents (OR = 3.96; 95% CI = 1.62-9.65). Male residents who died were younger compared with female residents (82.2 (standard deviation (SD) = 6.3) vs 89.1 (SD = 6.8) years; P < .001). CONCLUSION: NH residents in the 14 facilities we studied were severely affected by the COVID-19 pandemic, with a mortality of 47.5%. Male NH residents with COVID-19 had worse outcomes than females. We did not find evidence for any protection against mortality by OAT, necessitating further research into strategies to mitigate poor outcome of COVID-19 in vulnerable NH populations. J Am Geriatr Soc 68:1647-1652, 2020.
Databáze: OpenAIRE
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