Background: Patients hospitalized with COVID-19 experienced an increased risk of venous thromboembolism. Aims: To evaluate the effect of chronic oral anticoagulation (OAC) therapy, both with vitamin K antagonists (VKAs) or direct oral anticoagulants (DOACs), on prognosis of COVID-19 older patients. Methods: Single-center prospective study conducted in the Emergency Department (ED) of a teaching hospital, referral center for COVID-19 in central Italy. We evaluated all the patients ≥ 65 years, consecutively admitted to our ED for confirmed COVID-19. We compared the clinical outcome of those who were on chronic OAC at ED admission with those who did not, using a propensity score matched paired cohort of controls. The primary study endpoint was all-cause in-hospital death. Patients were matched for age, sex, clinical comorbidities, and clinical severity at presentation (based on NEWS ≥ 6). Study parameters were assessed for association to all-cause in-hospital death by a multivariate Cox regression analysis to identify independent risk factor for survival. Results: Although overall mortality was slightly higher for anticoagulated patients compared to controls (63.3% vs 43.5%, p = 0.012), the multivariate adjusted hazard ratio (HR) for death was not significant (HR = 1.56 [0.78–3.12]; p = 0.208). Both DOACs (HR 1.46 [0.73–2.92]; p = 0.283) and VKAs (HR 1.14 [0.48–2.73]; p = 0.761) alone did not affect overall survival in our cohort. Conclusions: Among older patients hospitalized for COVID-19, chronic OAC therapy was not associated with a reduced risk of in-hospital death. Moreover, our data suggest similar outcome both for patients on VKAs or in patients on DOACs.

Covino, M., De Matteis, G., Della Polla, D., Burzo, M. L., Pascale, M. M., Santoro, M., De Cristofaro, R., Gasbarrini, A., De Candia, E., Franceschi, F., Does chronic oral anticoagulation reduce in-hospital mortality among COVID-19 older patients?, <<AGING CLINICAL AND EXPERIMENTAL RESEARCH>>, 2021; 33 (8): 2335-2343. [doi:10.1007/s40520-021-01924-w] [http://hdl.handle.net/10807/183221]

Does chronic oral anticoagulation reduce in-hospital mortality among COVID-19 older patients?

Covino, M.;De Matteis, G.;Pascale, M. M.;Santoro, M.;De Cristofaro, R.;Gasbarrini, A.;De Candia, E.;Franceschi, F.
2021

Abstract

Background: Patients hospitalized with COVID-19 experienced an increased risk of venous thromboembolism. Aims: To evaluate the effect of chronic oral anticoagulation (OAC) therapy, both with vitamin K antagonists (VKAs) or direct oral anticoagulants (DOACs), on prognosis of COVID-19 older patients. Methods: Single-center prospective study conducted in the Emergency Department (ED) of a teaching hospital, referral center for COVID-19 in central Italy. We evaluated all the patients ≥ 65 years, consecutively admitted to our ED for confirmed COVID-19. We compared the clinical outcome of those who were on chronic OAC at ED admission with those who did not, using a propensity score matched paired cohort of controls. The primary study endpoint was all-cause in-hospital death. Patients were matched for age, sex, clinical comorbidities, and clinical severity at presentation (based on NEWS ≥ 6). Study parameters were assessed for association to all-cause in-hospital death by a multivariate Cox regression analysis to identify independent risk factor for survival. Results: Although overall mortality was slightly higher for anticoagulated patients compared to controls (63.3% vs 43.5%, p = 0.012), the multivariate adjusted hazard ratio (HR) for death was not significant (HR = 1.56 [0.78–3.12]; p = 0.208). Both DOACs (HR 1.46 [0.73–2.92]; p = 0.283) and VKAs (HR 1.14 [0.48–2.73]; p = 0.761) alone did not affect overall survival in our cohort. Conclusions: Among older patients hospitalized for COVID-19, chronic OAC therapy was not associated with a reduced risk of in-hospital death. Moreover, our data suggest similar outcome both for patients on VKAs or in patients on DOACs.
Inglese
Covino, M., De Matteis, G., Della Polla, D., Burzo, M. L., Pascale, M. M., Santoro, M., De Cristofaro, R., Gasbarrini, A., De Candia, E., Franceschi, F., Does chronic oral anticoagulation reduce in-hospital mortality among COVID-19 older patients?, <<AGING CLINICAL AND EXPERIMENTAL RESEARCH>>, 2021; 33 (8): 2335-2343. [doi:10.1007/s40520-021-01924-w] [http://hdl.handle.net/10807/183221]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/183221
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