Regular Use of VKA Prior to COVID-19 Associated with Lower 7-Day Survival in Hospitalized Frail Elderly COVID-19 Patients: The GERIA-COVID Cohort Study.


Journal

Nutrients
ISSN: 2072-6643
Titre abrégé: Nutrients
Pays: Switzerland
ID NLM: 101521595

Informations de publication

Date de publication:
24 Dec 2020
Historique:
received: 26 11 2020
revised: 20 12 2020
accepted: 22 12 2020
entrez: 30 12 2020
pubmed: 31 12 2020
medline: 13 1 2021
Statut: epublish

Résumé

Vitamin K concentrations are inversely associated with the clinical severity of COVID-19. The objective of this cohort study was to determine whether the regular use of vitamin K antagonist (VKA) prior to COVID-19 was associated with short-term mortality in frail older adults hospitalized for COVID-19. Eighty-two patients consecutively hospitalized for COVID-19 in a geriatric acute care unit were included. The association of the regular use of VKA prior to COVID-19 with survival after 7 days of COVID-19 was examined using a propensity-score-weighted Cox proportional-hazards model accounting for age, sex, severe undernutrition, diabetes mellitus, hypertension, prior myocardial infarction, congestive heart failure, prior stroke and/or transient ischemic attack, CHA2DS2-VASc score, HAS-BLED score, and eGFR. Among 82 patients (mean ± SD age 88.8 ± 4.5 years; 48% women), 73 survived COVID-19 at day 7 while 9 died. There was no between-group difference at baseline, despite a trend for more frequent use of VKA in those who did not survive on day 7 (33.3% versus 8.2%, Regular use of VKA was associated with increased mortality at day 7 in hospitalized frail elderly patients with COVID-19.

Sections du résumé

BACKGROUND BACKGROUND
Vitamin K concentrations are inversely associated with the clinical severity of COVID-19. The objective of this cohort study was to determine whether the regular use of vitamin K antagonist (VKA) prior to COVID-19 was associated with short-term mortality in frail older adults hospitalized for COVID-19.
METHODS METHODS
Eighty-two patients consecutively hospitalized for COVID-19 in a geriatric acute care unit were included. The association of the regular use of VKA prior to COVID-19 with survival after 7 days of COVID-19 was examined using a propensity-score-weighted Cox proportional-hazards model accounting for age, sex, severe undernutrition, diabetes mellitus, hypertension, prior myocardial infarction, congestive heart failure, prior stroke and/or transient ischemic attack, CHA2DS2-VASc score, HAS-BLED score, and eGFR.
RESULTS RESULTS
Among 82 patients (mean ± SD age 88.8 ± 4.5 years; 48% women), 73 survived COVID-19 at day 7 while 9 died. There was no between-group difference at baseline, despite a trend for more frequent use of VKA in those who did not survive on day 7 (33.3% versus 8.2%,
CONCLUSIONS CONCLUSIONS
Regular use of VKA was associated with increased mortality at day 7 in hospitalized frail elderly patients with COVID-19.

Identifiants

pubmed: 33374341
pii: nu13010039
doi: 10.3390/nu13010039
pmc: PMC7824717
pii:
doi:

Substances chimiques

Anticoagulants 0
Vitamin K 12001-79-5

Types de publication

Clinical Trial Journal Article Observational Study

Langues

eng

Sous-ensembles de citation

IM

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Auteurs

Pierre Ménager (P)

Department of Geriatric Medicine, Le Mans Hospital, F-72037 Le Mans, France.
Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity, University Hospital, F-49933 Angers, France.

Olivier Brière (O)

Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity, University Hospital, F-49933 Angers, France.

Jennifer Gautier (J)

Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity, University Hospital, F-49933 Angers, France.

Jérémie Riou (J)

INSERM, MINT, 1066, University of Angers, F-49000 Angers, France.
Delegation to Clinical Research and Innovation, Angers University Hospital, F-49933 Angers, France.

Guillaume Sacco (G)

Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity, University Hospital, F-49933 Angers, France.

Antoine Brangier (A)

Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity, University Hospital, F-49933 Angers, France.

Cédric Annweiler (C)

Department of Geriatric Medicine, Le Mans Hospital, F-72037 Le Mans, France.
Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity, University Hospital, F-49933 Angers, France.
UPRES EA 4638, University of Angers, F-49000 Angers, France.
Gérontopôle Autonomie Longévité des Pays de la Loire, F-44000 Nantes, France.
Robarts Research Institute, Department of Medical Biophysics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON N6A 5K8, Canada.

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