Clinical impact of pre-admission antithrombotic therapy in hospitalized patients with COVID-19: A multicenter observational study
- PMID: 32474087
- PMCID: PMC7256617
- DOI: 10.1016/j.phrs.2020.104965
Clinical impact of pre-admission antithrombotic therapy in hospitalized patients with COVID-19: A multicenter observational study
Abstract
Little is still known about the clinical features associated with the occurrence of acute respiratory distress syndrome (ARDS) in hospitalized patients with Coronavirus disease 2019 (COVID-19). The aim of the present study was to describe the prevalence of pre-admission antithrombotic therapies in patients with COVID-19 and to investigate the potential association between antithrombotic therapy and ARDS, as disease clinical presentation, or in-hospital mortality. We enrolled 192 consecutive patients with laboratory-confirmed COVID-19 admitted to emergency department of five Italian hospitals. The study population was divided in two groups according to the evidence of ARDS at chest computed tomography at admission. Propensity score weighting adjusted regression analysis was performed to assess the risk ARDS at admission, and death during hospitalization, in patients treated or not with antiplatelet and anticoagulant agents. ARDS was reported in 73 cases (38 %), who showed more likely hypertension compared to those without ARDS (57.8 % vs 49.6 %; P = 0.005). Thirty-five patients (18.5 %) died during the hospitalization. Not survived COVID-19 patients showed a statistically significant increased age (77 ± 8.31 vs 65.57 ± 8.31; P = 0.001), hypertension (77.1 % vs 53.5 %; P = 0.018) and coronary artery disease prevalence (28.6 % vs 10.2 %; P = 0.009). Both unadjusted and adjusted regression analyses showed no difference in the risk of ARDS at admission, or death during hospitalization, between patients treated or not with antiplatelets or anticoagulants. Pre-admission antithrombotic therapy, both antiplatelet and anticoagulant, does not seem to show a protective effect in severe forms of COVID-19 with ARDS at presentation and rapidly evolving toward death.
Keywords: Acute distress respiratory syndrome; Anticoagulant therapy; Anticoagulation; Antiplatelet therapy; Atrial fibrillation; COVID-19; Mortality; SARS-CoV-2.
Copyright © 2020 Elsevier Ltd. All rights reserved.
Conflict of interest statement
No conflict of interest or any financial support to declare
Figures
Comment in
-
Anticoagulant or antiplatelet use and severe COVID-19 disease: A propensity score-matched territory-wide study.Pharmacol Res. 2021 Mar;165:105473. doi: 10.1016/j.phrs.2021.105473. Epub 2021 Jan 30. Pharmacol Res. 2021. PMID: 33524539 Free PMC article. No abstract available.
Similar articles
-
Effect of Dexamethasone on Days Alive and Ventilator-Free in Patients With Moderate or Severe Acute Respiratory Distress Syndrome and COVID-19: The CoDEX Randomized Clinical Trial.JAMA. 2020 Oct 6;324(13):1307-1316. doi: 10.1001/jama.2020.17021. JAMA. 2020. PMID: 32876695 Free PMC article. Clinical Trial.
-
Corticosteroid therapy for coronavirus disease 2019-related acute respiratory distress syndrome: a cohort study with propensity score analysis.Crit Care. 2020 Nov 10;24(1):643. doi: 10.1186/s13054-020-03340-4. Crit Care. 2020. PMID: 33172477 Free PMC article.
-
Preadmission Statin Therapy and Clinical Outcome in Hospitalized Patients With COVID-19: An Italian Multicenter Observational Study.J Cardiovasc Pharmacol. 2021 Jul 1;78(1):e94-e100. doi: 10.1097/FJC.0000000000001041. J Cardiovasc Pharmacol. 2021. PMID: 34173802 Free PMC article.
-
Tocilizumab for the treatment of severe COVID-19 pneumonia with hyperinflammatory syndrome and acute respiratory failure: A single center study of 100 patients in Brescia, Italy.Autoimmun Rev. 2020 Jul;19(7):102568. doi: 10.1016/j.autrev.2020.102568. Epub 2020 May 3. Autoimmun Rev. 2020. PMID: 32376398 Free PMC article. Review.
-
Viral Coagulopathy in Patients With COVID-19: Treatment and Care.Clin Appl Thromb Hemost. 2020 Jan-Dec;26:1076029620936776. doi: 10.1177/1076029620936776. Clin Appl Thromb Hemost. 2020. PMID: 32687449 Free PMC article. Review.
Cited by
-
Use of antiplatelet drugs and the risk of mortality in patients with COVID-19: a meta-analysis.J Thromb Thrombolysis. 2021 Jul;52(1):124-129. doi: 10.1007/s11239-021-02436-0. Epub 2021 Apr 4. J Thromb Thrombolysis. 2021. PMID: 33813716 Free PMC article. No abstract available.
-
Anticoagulation outcomes in hospitalized Covid-19 patients: A systematic review and meta-analysis of case-control and cohort studies.Rev Med Virol. 2021 May;31(3):e2180. doi: 10.1002/rmv.2180. Epub 2020 Oct 6. Rev Med Virol. 2021. PMID: 33022834 Free PMC article.
-
Extracardiac Prothrombotic Effects of COVID-19.Heart Fail Clin. 2023 Apr;19(2):213-220. doi: 10.1016/j.hfc.2022.08.008. Heart Fail Clin. 2023. PMID: 36863813 Free PMC article. Review.
-
Chronic Oral Anticoagulation and Clinical Outcome in Hospitalized COVID-19 Patients.Cardiovasc Drugs Ther. 2022 Aug;36(4):705-712. doi: 10.1007/s10557-021-07194-y. Epub 2021 May 14. Cardiovasc Drugs Ther. 2022. PMID: 33988835 Free PMC article.
-
Coagulopathy in COVID-19: Focus on vascular thrombotic events.J Mol Cell Cardiol. 2020 Sep;146:32-40. doi: 10.1016/j.yjmcc.2020.07.003. Epub 2020 Jul 15. J Mol Cell Cardiol. 2020. PMID: 32681845 Free PMC article. Review.
References
-
- Hui D.S., I.A. E, Madani T.A., Ntoumi F., Kock R., Dar O. The continuing 2019-nCoV epidemic threat of novel coronaviruses to global health - the latest 2019 novel coronavirus outbreak in Wuhan, China. Int. J. Infect. Dis. 2020;91:264–266. doi: 10.1016/j.ijid.2020.01.009. Epub 2020 Jan 14. - DOI - PMC - PubMed
-
- World Health Organization Coronavirus disease (COVID-19) Situation Report - 103. https://www.who.int/docs/default-source/coronaviruse/situation-reports/2... (Accessed 2 May 2020)
-
- Ranieri V.M., Rubenfeld G.D., Thompson B.T. ARDS definition task force. Acute respiratory distress syndrome: the Berlin definition. JAMA. 2012;307(23):2526–2533. - PubMed
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Miscellaneous