tetano
Editor, Senior Moderator
Eur J Med Res
. 2025 Aug 25;30(1):800.
doi: 10.1186/s40001-025-03041-0. Impact of prophylactic anticoagulation on hospitalized COVID-19 patients aged over 80 years: a multicenter prospective cohort study
Feiya Xu[SUP] #[/SUP][SUP] 1 2 3 [/SUP], Guohui Fan[SUP] #[/SUP][SUP] 2 3 [/SUP], Jing Han[SUP] #[/SUP][SUP] 4 [/SUP], Yuzhi Tao[SUP] 2 5 [/SUP], Lijun Chen[SUP] 6 [/SUP], Yunhui Zhang[SUP] 7 [/SUP], Binliang Wang[SUP] 4 [/SUP], Chaosheng Deng[SUP] 8 [/SUP], Weijia Liu[SUP] 9 [/SUP], Yunxia Zhang[SUP] 2 [/SUP], Zhu Zhang[SUP] 2 [/SUP], Shuai Zhang[SUP] 2 [/SUP], Yeming Wang[SUP] 2 [/SUP], Jun Wan[SUP] 6 [/SUP], Wanmu Xie[SUP] 2 [/SUP], Peiran Yang[SUP] 10 [/SUP], Wenbin Wu[SUP] 11 [/SUP], Dingyi Wang[SUP] 12 [/SUP], Chen Wang[SUP] 13 14 [/SUP], Zhenguo Zhai[SUP] 15 [/SUP]
Affiliations
Background: Individuals aged 80 and older face a notably increased risk of venous thromboembolism (VTE) and mortality after SARS-CoV-2 infection. Clinical guidelines recommend routine pharmacological thromboprophylaxis, yet its application in oldest-old patients remains insufficiently studied.
Aims: To assess the efficacy and safety of low-molecular-weight heparin (LMWH) thromboprophylaxis in hospitalized COVID-19 patients aged 80 years and older.
Methods: We conducted a multicenter, prospective cohort study enrolling in-hospital COVID-19 patients aged ≥ 80 years from six tertiary hospitals in China between December 2022 and January 2023. The clinical outcomes were VTE, all-cause mortality and bleeding events. Patients were followed up for 3 months after discharge. Multivariate Cox regression models were used to identify risk factors and evaluate the impact of LMWH prophylaxis on clinical outcomes.
Results: Among 1526 patients aged ≥ 80 years, 41.6% received LMWH prophylaxis. LMWH prophylaxis significantly reduced VTE risk by 50% (HR 0.50, 95% CI 0.33-0.75) and mortality risk by 20% (HR 0.80, 95% CI 0.65-0.99), without increasing bleeding risk (HR 0.90, 95% CI 0.60-1.34). Male, history of stroke, critical illness on admission and hemoglobin < 90 g/L were identified as risk factors of bleeding. LMWH prophylaxis remained effective in preventing VTE and demonstrated favorable safety particularly in male patients and patients with hemoglobin < 90 g/L.
Discussion and conclusion: LMWH may be safe and effective for thromboprophylaxis in the oldest-old COVID-19 patients, even in patients with high bleeding risk. Further studies are needed to verify our findings.
Keywords: COVID-19; Older people; Thromboprophylaxis; VTE.
. 2025 Aug 25;30(1):800.
doi: 10.1186/s40001-025-03041-0. Impact of prophylactic anticoagulation on hospitalized COVID-19 patients aged over 80 years: a multicenter prospective cohort study
Feiya Xu[SUP] #[/SUP][SUP] 1 2 3 [/SUP], Guohui Fan[SUP] #[/SUP][SUP] 2 3 [/SUP], Jing Han[SUP] #[/SUP][SUP] 4 [/SUP], Yuzhi Tao[SUP] 2 5 [/SUP], Lijun Chen[SUP] 6 [/SUP], Yunhui Zhang[SUP] 7 [/SUP], Binliang Wang[SUP] 4 [/SUP], Chaosheng Deng[SUP] 8 [/SUP], Weijia Liu[SUP] 9 [/SUP], Yunxia Zhang[SUP] 2 [/SUP], Zhu Zhang[SUP] 2 [/SUP], Shuai Zhang[SUP] 2 [/SUP], Yeming Wang[SUP] 2 [/SUP], Jun Wan[SUP] 6 [/SUP], Wanmu Xie[SUP] 2 [/SUP], Peiran Yang[SUP] 10 [/SUP], Wenbin Wu[SUP] 11 [/SUP], Dingyi Wang[SUP] 12 [/SUP], Chen Wang[SUP] 13 14 [/SUP], Zhenguo Zhai[SUP] 15 [/SUP]
Affiliations
- PMID: 40855333
- PMCID: PMC12376747
- DOI: 10.1186/s40001-025-03041-0
Background: Individuals aged 80 and older face a notably increased risk of venous thromboembolism (VTE) and mortality after SARS-CoV-2 infection. Clinical guidelines recommend routine pharmacological thromboprophylaxis, yet its application in oldest-old patients remains insufficiently studied.
Aims: To assess the efficacy and safety of low-molecular-weight heparin (LMWH) thromboprophylaxis in hospitalized COVID-19 patients aged 80 years and older.
Methods: We conducted a multicenter, prospective cohort study enrolling in-hospital COVID-19 patients aged ≥ 80 years from six tertiary hospitals in China between December 2022 and January 2023. The clinical outcomes were VTE, all-cause mortality and bleeding events. Patients were followed up for 3 months after discharge. Multivariate Cox regression models were used to identify risk factors and evaluate the impact of LMWH prophylaxis on clinical outcomes.
Results: Among 1526 patients aged ≥ 80 years, 41.6% received LMWH prophylaxis. LMWH prophylaxis significantly reduced VTE risk by 50% (HR 0.50, 95% CI 0.33-0.75) and mortality risk by 20% (HR 0.80, 95% CI 0.65-0.99), without increasing bleeding risk (HR 0.90, 95% CI 0.60-1.34). Male, history of stroke, critical illness on admission and hemoglobin < 90 g/L were identified as risk factors of bleeding. LMWH prophylaxis remained effective in preventing VTE and demonstrated favorable safety particularly in male patients and patients with hemoglobin < 90 g/L.
Discussion and conclusion: LMWH may be safe and effective for thromboprophylaxis in the oldest-old COVID-19 patients, even in patients with high bleeding risk. Further studies are needed to verify our findings.
Keywords: COVID-19; Older people; Thromboprophylaxis; VTE.