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Multicenter Study
. 2022 Aug;36(4):705-712.
doi: 10.1007/s10557-021-07194-y. Epub 2021 May 14.

Chronic Oral Anticoagulation and Clinical Outcome in Hospitalized COVID-19 Patients

Vincenzo Russo  1 , Roberta Bottino  2 , Antonello D'Andrea  3 , Angelo Silverio  4 , Marco Di Maio  4   5 , Paolo Golino  1 , Gerardo Nigro  1 , Orazio Valsecchi  6 , Emilio Attena  7 , Mario Enrico Canonico  8 , Gennaro Galasso  4 , Guido Parodi  8 , Fernando Scudiero  6
Affiliations
Multicenter Study

Chronic Oral Anticoagulation and Clinical Outcome in Hospitalized COVID-19 Patients

Vincenzo Russo et al. Cardiovasc Drugs Ther. 2022 Aug.

Abstract

Purpose: The clinical course of COVID-19 may be complicated by acute respiratory distress syndrome (ARDS) and thromboembolic events, which are associated with high risk of mortality. Although previous studies reported a lower rate of death in patients treated with heparin, the potential benefit of chronic oral anticoagulation therapy (OAT) remains unknown. We aimed to investigate the association between OAT with the risk of ARDS and mortality in hospitalized patients with COVID-19.

Methods: This is a multicenter retrospective Italian study including consecutive patients hospitalized for COVID-19 from March 1 to April 22, 2020, at six Italian hospitals. Patients were divided into two groups according to the chronic assumption of oral anticoagulants.

Results: Overall, 427 patients were included; 87 patients (19%) were in the OAT group. Of them, 54 patients (13%) were on treatment with non-vitamin k oral anticoagulants (NOACs) and 33 (8%) with vitamin-K antagonists (VKAs). OAT patients were older and had a higher rate of hypertension, diabetes, and coronary artery disease compared to No-OAT group. The rate of ARDS at admission (26% vs 28%, P=0.834), or developed during the hospitalization (9% vs 10%, P=0.915), was similar between study groups; in-hospital mortality (22% vs 26%, P=0.395) was also comparable. After balancing for potential confounders by using the propensity score matching technique, no differences were found in term of clinical outcome between OAT and No-OAT patients CONCLUSION: Oral anticoagulation therapy, either NOACs or VKAs, did not influence the risk of ARDS or death in patients hospitalized with COVID-19.

Keywords: ARDS; COVID-19; NOACs; Outcome; SARS-CoV-2; VKA.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Kaplan-Meier survival free from in-hospital mortality according to anticoagulation therapy (OAT) in unmatched (panel A) and matched (panel B) cohorts
See this image and copyright information in PMC

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