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Multicenter Study
. 2023 Jan-Dec:29:10760296231177017.
doi: 10.1177/10760296231177017.

Doxycycline's Potential Role in Reducing Thrombosis and Mortality in Critically Ill Patients With COVID-19: A Multicenter Cohort Study

Khalid Al Sulaiman  1   2   3   4 , Ohoud Aljuhani  5 , Ghazwa B Korayem  6 , Lina I Alnajjar  6   7 , Ali F Altebainawi  8   9 , Mashael AlFaifi  1   10 , Ramesh Vishwakarma  11 , Abeer A Alenazi  12 , Mai Alalawi  13 , Abdulrahman Alissa  7 , Yazed S Alsowaida  9 , Samiah Alsohimi  14 , Alaa Almagthali  14 , Saeed M Alay  2 , Noora Altaher  2 , Mohammed G Alamri  2 , Dalal Alangari  2 , Amer Alzahrani  15 , Habeeb Ibrahim Abdul Razack  16   17 , Jwael Alhamoud  18 , Abdulrahman Alshaya  1   2   3 , Jawaher Gramish  1   2   3 , Kholoud Al Aamer  1   3 , Alawi S Alsaeedi  3   19   20 , Ghassan Alghamdi  3   19   20
Affiliations
Multicenter Study

Doxycycline's Potential Role in Reducing Thrombosis and Mortality in Critically Ill Patients With COVID-19: A Multicenter Cohort Study

Khalid Al Sulaiman et al. Clin Appl Thromb Hemost. 2023 Jan-Dec.

Abstract

Doxycycline has revealed potential effects in animal studies to prevent thrombosis and reduce mortality. However, less is known about its antithrombotic role in patients with COVID-19. Our study aimed to evaluate doxycycline's impact on clinical outcomes in critically ill patients with COVID-19. A multicenter retrospective cohort study was conducted between March 1, 2020, and July 31, 2021. Patients who received doxycycline in intensive care units (ICUs) were compared to patients who did not (control). The primary outcome was the composite thrombotic events. The secondary outcomes were 30-day and in-hospital mortality, length of stay, ventilator-free days, and complications during ICU stay. Propensity score (PS) matching was used based on the selected criteria. Logistic, negative binomial, and Cox proportional hazards regression analyses were used as appropriate. After PS (1:3) matching, 664 patients (doxycycline n = 166, control n = 498) were included. The number of thromboembolic events was lower in the doxycycline group (OR: 0.54; 95% CI: 0.26-1.08; P = .08); however, it failed to reach to a statistical significance. Moreover, D-dimer levels and 30-day mortality were lower in the doxycycline group (beta coefficient [95% CI]: -0.22 [-0.46, 0.03; P = .08]; HR: 0.73; 95% CI: 0.52-1.00; P = .05, respectively). In addition, patients who received doxycycline had significantly lower odds of bacterial/fungal pneumonia (OR: 0.65; 95% CI: 0.44-0.94; P = .02). The use of doxycycline as adjunctive therapy in critically ill patients with COVID-19 might may be a desirable therapeutic option for thrombosis reduction and survival benefits.

Keywords: COVID-19; SARS-CoV-2; critically ill; doxycycline; intensive care units; mortality; thrombosis.

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Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Flow diagram showing patients recruited with COVID-19.
See this image and copyright information in PMC

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