Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Apr 1;23(4):264-271.
doi: 10.2459/JCM.0000000000001284.

Pre- and in-hospital anticoagulation therapy in coronavirus disease 2019 patients: a propensity-matched analysis of in-hospital outcomes

Ilaria Battistoni  1 , Matteo Francioni  1 , Nuccia Morici  2   3 , Andrea Rubboli  4 , Gian Marco Podda  5 , Andrea Pappalardo  6 , Mohamed E A Abdelrahim  7 , Marwa O Elgendy  8   9 , Sara O Elgendy  10 , Ahmed M Khalaf  11 , Ahmed Abdel M Hamied  12 , Héctor Hernández Garcés  13 , Omar E S Abdelhamid  14 , Karim A M Tawfik  15 , Anna Zeduri  16 , Gabriele Bassi  17 , Giulia Pongetti  1 , Luca Angelini  1 , Stefano Giovinazzo  18 , Pablo Martinez Garcia  19 , Francesco Saverio Serino  20 , Giorgio Emanuele Polistina  21 , Giuseppe Fiorentino  21 , Giovanni Barbati  22 , Anna Toniolo  23 , Azzurra Fabbrizioli  24 , Alberto Belenguer-Muncharaz  25 , Italo Porto  18   26 , Sibel Ocak  27 , Pietro Minuz  28 , Francisco Bernal  29 , Irina Hermosilla  29 , Josip A Borovac  30
Affiliations

Pre- and in-hospital anticoagulation therapy in coronavirus disease 2019 patients: a propensity-matched analysis of in-hospital outcomes

Ilaria Battistoni et al. J Cardiovasc Med (Hagerstown). .

Abstract

Aims: To estimate if chronic anticoagulant (CAC) treatment is associated with morbidity and mortality outcomes of patients hospitalized for SARS-CoV-2 infection.

Methods: In this European multicentric cohort study, we included 1186 patients of whom 144 were on CAC (12.1%) with positive coronavirus disease 2019 testing between 1 February and 30 July 2020. The average treatment effect (ATE) analysis with a propensity score-matching (PSM) algorithm was used to estimate the impact of CAC on the primary outcomes defined as in-hospital death, major and minor bleeding events, cardiovascular complications (CCI), and acute kidney injury (AKI). We also investigated if different dosages of in-hospital heparin were associated with in-hospital survival.

Results: In unadjusted populations, primary outcomes were significantly higher among CAC patients compared with non-CAC patients: all-cause death (35% vs. 18% P < 0.001), major and minor bleeding (14% vs. 8% P = 0.026; 25% vs. 17% P = 0.014), CCI (27% vs. 14% P < 0.001), and AKI (42% vs. 19% P < 0.001). In ATE analysis with PSM, there was no significant association between CAC and primary outcomes except for an increased incidence of AKI (ATE +10.2%, 95% confidence interval 0.3-20.1%, P = 0.044). Conversely, in-hospital heparin, regardless of dose, was associated with a significantly higher survival compared with no anticoagulation.

Conclusions: The use of CAC was not associated with the primary outcomes except for the increase in AKI. However, in the adjusted survival analysis, any dose of in-hospital anticoagulation was associated with significantly higher survival compared with no anticoagulation.

PubMed Disclaimer

References

    1. Klok FA, Kruip MJHA, Van der Meer NJM, et al. Incidence of thrombotic complications in critically ill ICU patients with COVID-19. Thromb Res 2020; 191:145–147.
    1. Cui S, Chen S, Li X, Liu S, Wang F. Prevalence of venous thromboembolism in patients with severe novel coronavirus pneumonia. J Thromb Haemost 2020; 18:1421–1424.
    1. Llitjos JF, Leclerc M, Chochois C, et al. High incidence of venous thromboembolic events in anticoagulated severe COVID-19 patients. J Thromb Haemost 2020; 18:1743–1746.
    1. Lodigiani C, Iapichino G, Carenzo L, et al. Humanitas COVID-19 Task Force. Venous and arterial thromboembolic complications in COVID-19 patients admitted to an academic hospital in Milan, Italy. Thromb Res 2020; 191:9–14.
    1. Ackermann M, Verleden SE, Kuehnel M, et al. Pulmonary vascular endothelialitis, thrombosis, and angiogenesis in Covid-19. N Engl J Med 2020; 383:120–128.