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. 2023 Mar;46(3):273-281.
doi: 10.1007/s40264-022-01266-0. Epub 2022 Dec 23.

Effect of Previous Anticoagulant Treatment on Risk of COVID-19

Maruxa Zapata-Cachafeiro  1   2   3 , Ángela Prieto-Campo  1 , Manuel Portela-Romero  4   5 , Eduardo Carracedo-Martínez  6 , Martina Lema-Oreiro  7 , María Piñeiro-Lamas  2   3 , Somnath Chaudhuri  8   9 , Ángel Salgado-Barreira  10   11   12 , Adolfo Figueiras  1   2   3
Affiliations

Effect of Previous Anticoagulant Treatment on Risk of COVID-19

Maruxa Zapata-Cachafeiro et al. Drug Saf. 2023 Mar.

Abstract

Introduction: Little is known about the role played by anticoagulants in COVID-19.

Objective: The aim of this study was to assess the impact of previous anticoagulant treatment on risk of hospitalization due to COVID-19, progression to severe COVID-19 and susceptibility to COVID-19 infection.

Methods: We conducted a multiple population-based case-control study in northwest Spain, in 2020, to assess (1) risk of hospitalization: cases were all patients admitted due to COVID-19 with PCR confirmation, and controls were a random matched sample of subjects without a positive PCR; (2) progression: cases were hospitalized COVID-19 subjects, and controls were all non-hospitalized COVID-19 patients; and (3) susceptibility: cases were patients with a positive PCR (hospitalized and non-hospitalized), and the controls were the same as for the hospitalization model. Adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated using a generalized linear mixed model.

Results: The consumption of antivitamin K and direct-acting anticoagulants apparently was not associated with the risk of progression to severe COVID-19 (OR 0.93 [95% CI 0.74-1.17] and OR 1.04 [95% CI 0.79-1.36], respectively). Antivitamin K anticoagulants were associated with a significantly lower risk of hospitalization (OR 0.77 [95% CI 0.64-0.93]), which, in part, can be explained by a decreased risk of susceptibility to infection (OR 0.83 [95% CI 0.74-0.92]). The use of direct-acting anticoagulants was not associated with the risk of hospitalization, although it also seems to decrease susceptibility (OR 0.85 [95% CI 0.74-0.98]). It has also been observed that low-molecular-weight heparins were associated with an increased risk of progression to severe COVID-19 (OR 1.25 [95% CI 1.01-1.55]).

Conclusion: The results of this study have shown that antivitamin K anticoagulants and direct-acting anticoagulants do not increase the risk of progression to more severe stages. Antivitamin K consumption was associated with a lower risk of hospitalization and susceptibility to infection.

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Conflict of interest statement

The authors declare they have no conflicts of interest.

Figures

Fig. 1
Fig. 1
Odds ratios of the association between current use of direct-acting oral anticoagulants, vitamin K antagonists, low-molecular-weight heparins (LMWH) and COVID-19-related outcomes
See this image and copyright information in PMC

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