According to new findings published in the May 6th issue of Journal of the American College of Cardiology, providing hospitalized COVID-19 patients with anticoagulants is associated with improved outcomes. Researchers evaluated the correlation between in-hospital anticoagulation administration and mortality among patients hospitalized with COVID-19. The researchers adjusted for age; gender; ethnicity; history of hypertension, heart failure, atrial fibrillation, and T2DM; anticoagulation use prior to hospitalization; and admission date. Moreover, the extent of anticoagulation treatment was utilized as a covariate, and intubation was treated as a time-dependent variable.
The findings from this recently published study could provide clinicians with new understanding regarding the best practices for treating and managing patients once they are admitted to the hospital. Researchers explored data from 2,773 patients treated at one of five hospitals in the Mount Sinai Health System in New York City between March 14 and April 11, 2020. These findings reported that of 2,773 hospitalized COVID-19 patients, 786 (28%) received systemic anticoagulation during their hospital stay. The median length of stay was 5 days, whereas the median time from admission to anticoagulation initiation was 2 days and the median anticoagulation duration was 3 days.
Among patients who received anticoagulation, in-hospital mortality was 22.5% with a median survival of 21 days, compared with 22.8% and a median survival of 14 days among patients who did not receive anticoagulation. Patients who received anticoagulation were more likely to need mechanical ventilation (29.8% vs. 8.1%). In-hospital mortality among patients requiring mechanical ventilation was 29.1% with a median survival of 21 days for those receiving anticoagulation versus 62.7% with a median survival of 9 days for patients not receiving anticoagulation.
Longer duration of anticoagulation treatment was linked to a diminished mortality risk (adjusted hazard ratio, 0.86 per day; 95% CI, 0.82-0.89; P <.001). In addition, 24 patients (3%) who received anticoagulation had bleeding events, compared with 38 patients (1.9%) of those who did not receive anticoagulation. Bleeding events were more common among patients who were intubated (7.5%) versus nonintubated patients (1.35%).
The researchers concluded that anticoagulation may be linked to enhanced outcomes in COVID-19 patients, but the benefits should be weighed against the risk of bleeding. The findings provide clinical insights on hospitalized COVID-19 patients, but further research is required to ascertain whether systemic anticoagulation is linked to augmented survival.
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