Rivera-Caravaca, Jose Miguel 
ORCID: 0000-0003-0492-6241, Nunez-Gil, Ivan J, Lip, Gregory YH ORCID: 0000-0002-7566-1626, Uribarri, Aitor, Viana-Llamas, Maria C, Gonzalez, Adelina, Castro-Mejia, Alex F, Gonzalez, Berta Alonso, Alfonso, Emilio, Garcia Prieto, Juan Fortunato et al (show 21 more authors)
(2022)
Chronic Oral Anticoagulation Therapy and Prognosis of Patients Admitted to Hospital for COVID-19: Insights from the HOPE COVID-19 Registry.
INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, 2022.
7325060-.
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Abstract
<h4>Background</h4>Most evidence regarding anticoagulation and COVID-19 refers to the hospitalization setting, but the role of oral anticoagulation (OAC) before hospital admission has not been well explored. We compared clinical outcomes and short-term prognosis between patients with and without prior OAC therapy who were hospitalized for COVID-19.<h4>Methods</h4>Analysis of the whole cohort of the HOPE COVID-19 Registry which included patients discharged (deceased or alive) after hospital admission for COVID-19 in 9 countries. All-cause mortality was the primary endpoint. Study outcomes were compared after adjusting variables using propensity score matching (PSM) analyses.<h4>Results</h4>7698 patients were suitable for the present analysis (675 (8.8%) on OAC at admission: 427 (5.6%) on VKAs and 248 (3.2%) on DOACs). After PSM, 1276 patients were analyzed (638 with OAC; 638 without OAC), without significant differences regarding the risk of thromboembolic events (OR 1.11, 95% CI 0.59-2.08). The risk of clinically relevant bleeding (OR 3.04, 95% CI 1.92-4.83), as well as the risk of mortality (HR 1.22, 95% CI 1.01-1.47; log-rank <i>p</i> value = 0.041), was significantly increased in previous OAC users. Amongst patients on prior OAC only, there were no differences in the risk of clinically relevant bleeding, thromboembolic events, or mortality when comparing previous VKA or DOAC users, after PSM.<h4>Conclusion</h4>Hospitalized COVID-19 patients on prior OAC therapy had a higher risk of mortality and worse clinical outcomes compared to patients without prior OAC therapy, even after adjusting for comorbidities using a PSM. There were no differences in clinical outcomes in patients previously taking VKAs or DOACs. This trial is registered with NCT04334291/EUPAS34399.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Humans, Atrial Fibrillation, Thromboembolism, Hemorrhage, Anticoagulants, Prognosis, Hospitalization, Administration, Oral, Registries, Hospitals, COVID-19 Drug Treatment |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Faculty Management Office Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 25 Oct 2022 15:55 |
| Last Modified: | 14 Feb 2023 21:29 |
| DOI: | 10.1155/2022/7325060 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3165760 |
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