Clinical outcomes and the impact of prior oral anticoagulant use in patients with coronavirus disease 2019 admitted to hospitals in the UK - a multicentre observational study.
Administration, Oral
Adult
Aged
Aged, 80 and over
Anticoagulants
/ adverse effects
COVID-19
/ complications
Female
Hemorrhage
/ chemically induced
Hospitalization
Humans
Intensive Care Units
Male
Middle Aged
SARS-CoV-2
/ isolation & purification
Severity of Illness Index
Thrombosis
/ complications
United Kingdom
/ epidemiology
anticoagulation
bleeding
coronavirus disease 2019
mortality
thrombosis
Journal
British journal of haematology
ISSN: 1365-2141
Titre abrégé: Br J Haematol
Pays: England
ID NLM: 0372544
Informations de publication
Date de publication:
01 2022
01 2022
Historique:
received:
10
07
2021
accepted:
07
08
2021
pubmed:
10
9
2021
medline:
12
1
2022
entrez:
9
9
2021
Statut:
ppublish
Résumé
Coagulation dysfunction and thrombosis are major complications in patients with coronavirus disease 2019 (COVID-19). Patients on oral anticoagulants (OAC) prior to diagnosis of COVID-19 may therefore have better outcomes. In this multicentre observational study of 5 883 patients (≥18 years) admitted to 26 UK hospitals between 1 April 2020 and 31 July 2020, overall mortality was 29·2%. Incidences of thrombosis, major bleeding (MB) and multiorgan failure (MOF) were 5·4%, 1·7% and 3·3% respectively. The presence of thrombosis, MB, or MOF was associated with a 1·8, 4·5 or 5·9-fold increased risk of dying, respectively. Of the 5 883 patients studied, 83·6% (n = 4 920) were not on OAC and 16·4% (n = 963) were taking OAC at the time of admission. There was no difference in mortality between patients on OAC vs no OAC prior to admission when compared in an adjusted multivariate analysis [hazard ratio (HR) 1·05, 95% confidence interval (CI) 0·93-1·19; P = 0·15] or in an adjusted propensity score analysis (HR 0·92 95% CI 0·58-1·450; P = 0·18). In multivariate and adjusted propensity score analyses, the only significant association of no anticoagulation prior to diagnosis of COVID-19 was admission to the Intensive-Care Unit (ICU) (HR 1·98, 95% CI 1·37-2·85). Thrombosis, MB, and MOF were associated with higher mortality. Our results indicate that patients may have benefit from prior OAC use, especially reduced admission to ICU, without any increase in bleeding.
Substances chimiques
Anticoagulants
0
Types de publication
Journal Article
Multicenter Study
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
79-94Subventions
Organisme : Bayer plc
ID : P87339
Informations de copyright
© 2021 British Society for Haematology and John Wiley & Sons Ltd.
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