tetano
Editor, Senior Moderator
Clin Res Cardiol
. 2021 Sep 21.
doi: 10.1007/s00392-021-01939-3. Online ahead of print.
Pre-medication with oral anticoagulants is associated with better outcomes in a large multinational COVID-19 cohort with cardiovascular comorbidities
Marina Rieder[SUP] #[/SUP][SUP] 1 2 [/SUP], Nadine Gauchel[SUP] #[/SUP][SUP] 3 4 [/SUP], Klaus Kaier[SUP] 5 [/SUP], Carolin Jakob[SUP] 6 7 [/SUP], Stefan Borgmann[SUP] 8 [/SUP], Annika Y Classen[SUP] 6 7 [/SUP], Jochen Schneider[SUP] 9 [/SUP], Lukas Eberwein[SUP] 10 [/SUP], Martin Lablans[SUP] 11 12 [/SUP], Maria Rüthrich[SUP] 13 14 [/SUP], Sebastian Dolff[SUP] 15 [/SUP], Kai Wille[SUP] 16 [/SUP], Martina Haselberger[SUP] 17 [/SUP], Hanno Heuzeroth[SUP] 18 [/SUP], Christoph Bode[SUP] 1 2 [/SUP], Constantin von Zur Mühlen[SUP] 1 2 [/SUP], Siegbert Rieg[SUP] #[/SUP][SUP] 19 [/SUP], Daniel Duerschmied[SUP] #[/SUP][SUP] 1 2 [/SUP]
Affiliations
Abstract
Aims: Coagulopathy and venous thromboembolism are common findings in coronavirus disease 2019 (COVID-19) and are associated with poor outcome. Timely initiation of anticoagulation after hospital admission was shown to be beneficial. In this study we aim to examine the association of pre-existing oral anticoagulation (OAC) with outcome among a cohort of SARS-CoV-2 infected patients.
Methods and results: We analysed the data from the large multi-national Lean European Open Survey on SARS-CoV-2 infected patients (LEOSS) from March to August 2020. Patients with SARS-CoV-2 infection were eligible for inclusion. We retrospectively analysed the association of pre-existing OAC with all-cause mortality. Secondary outcome measures included COVID-19-related mortality, recovery and composite endpoints combining death and/or thrombotic event and death and/or bleeding event. We restricted bleeding events to intracerebral bleeding in this analysis to ensure clinical relevance and to limit reporting errors. A total of 1 433 SARS-CoV-2 infected patients were analysed, while 334 patients (23.3%) had an existing premedication with OAC and 1 099 patients (79.7%) had no OAC. After risk adjustment for comorbidities, pre-existing OAC showed a protective influence on the endpoint death (OR 0.62, P = 0.013) as well as the secondary endpoints COVID-19-related death (OR 0.64, P = 0.023) and non-recovery (OR 0.66, P = 0.014). The combined endpoint death or thrombotic event tended to be less frequent in patients on OAC (OR 0.71, P = 0.056).
Conclusions: Pre-existing OAC is protective in COVID-19, irrespective of anticoagulation regime during hospital stay and independent of the stage and course of disease.
Keywords: COVID-19; Oral anticoagulation; SARS-CoV-2; Thrombosis.
. 2021 Sep 21.
doi: 10.1007/s00392-021-01939-3. Online ahead of print.
Pre-medication with oral anticoagulants is associated with better outcomes in a large multinational COVID-19 cohort with cardiovascular comorbidities
Marina Rieder[SUP] #[/SUP][SUP] 1 2 [/SUP], Nadine Gauchel[SUP] #[/SUP][SUP] 3 4 [/SUP], Klaus Kaier[SUP] 5 [/SUP], Carolin Jakob[SUP] 6 7 [/SUP], Stefan Borgmann[SUP] 8 [/SUP], Annika Y Classen[SUP] 6 7 [/SUP], Jochen Schneider[SUP] 9 [/SUP], Lukas Eberwein[SUP] 10 [/SUP], Martin Lablans[SUP] 11 12 [/SUP], Maria Rüthrich[SUP] 13 14 [/SUP], Sebastian Dolff[SUP] 15 [/SUP], Kai Wille[SUP] 16 [/SUP], Martina Haselberger[SUP] 17 [/SUP], Hanno Heuzeroth[SUP] 18 [/SUP], Christoph Bode[SUP] 1 2 [/SUP], Constantin von Zur Mühlen[SUP] 1 2 [/SUP], Siegbert Rieg[SUP] #[/SUP][SUP] 19 [/SUP], Daniel Duerschmied[SUP] #[/SUP][SUP] 1 2 [/SUP]
Affiliations
- PMID: 34546427
- DOI: 10.1007/s00392-021-01939-3
Abstract
Aims: Coagulopathy and venous thromboembolism are common findings in coronavirus disease 2019 (COVID-19) and are associated with poor outcome. Timely initiation of anticoagulation after hospital admission was shown to be beneficial. In this study we aim to examine the association of pre-existing oral anticoagulation (OAC) with outcome among a cohort of SARS-CoV-2 infected patients.
Methods and results: We analysed the data from the large multi-national Lean European Open Survey on SARS-CoV-2 infected patients (LEOSS) from March to August 2020. Patients with SARS-CoV-2 infection were eligible for inclusion. We retrospectively analysed the association of pre-existing OAC with all-cause mortality. Secondary outcome measures included COVID-19-related mortality, recovery and composite endpoints combining death and/or thrombotic event and death and/or bleeding event. We restricted bleeding events to intracerebral bleeding in this analysis to ensure clinical relevance and to limit reporting errors. A total of 1 433 SARS-CoV-2 infected patients were analysed, while 334 patients (23.3%) had an existing premedication with OAC and 1 099 patients (79.7%) had no OAC. After risk adjustment for comorbidities, pre-existing OAC showed a protective influence on the endpoint death (OR 0.62, P = 0.013) as well as the secondary endpoints COVID-19-related death (OR 0.64, P = 0.023) and non-recovery (OR 0.66, P = 0.014). The combined endpoint death or thrombotic event tended to be less frequent in patients on OAC (OR 0.71, P = 0.056).
Conclusions: Pre-existing OAC is protective in COVID-19, irrespective of anticoagulation regime during hospital stay and independent of the stage and course of disease.
Keywords: COVID-19; Oral anticoagulation; SARS-CoV-2; Thrombosis.