Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, Indonesia.
Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, Indonesia.
Clin Appl Thromb Hemost. 2020 Jan-Dec;26:1076029620960797. doi: 10.1177/1076029620960797.
The incidence of venous thromboembolism (VTE) events in patients with COVID-19 treated with a standard thromboprophylaxis dose of anticoagulants remains high. We conducted a systematic review in order to explore the association between therapeutic-dose anticoagulation and its effect on mortality in patients with COVID-19. A systematic search was carried out using the electronic databases of PubMed, EuropePMC, and the Cochrane Central Database, using specific keywords. All articles that fulfilled the inclusion criteria were included in the qualitative analysis. There were 8 observational studies included in the final qualitative analysis. Quality assessment using the Newcastle-Ottawa Scale (NOS) showed a mean score of 7.5 ± 1.06, indicating moderate to high quality of the studies. Three retrospective cohort studies reported a reduction in the mortality rate, while 6 other studies showed no mortality benefits among patients with COVID-19 treated with therapeutic-dose anticoagulation. There was a slight tendency toward a reduction in the mortality rate among mechanically-ventilated patients with COVID-19 receiving therapeutic-dose anticoagulation. Bleeding events and thrombotic complications among patients receiving therapeutic-dose anticoagulation were reported in 3 studies. Although it is too soon to draw any conclusions, this systematic review draws attention to current evidence regarding the association between therapeutic-dose anticoagulation and its effect on mortality in patients with COVID-19.
COVID-19 患者接受标准剂量抗凝预防血栓栓塞事件（VTE）的发生率仍然较高。我们进行了一项系统评价，以探讨治疗剂量抗凝与 COVID-19 患者死亡率之间的关系。使用特定的关键词，在电子数据库 PubMed、EuropePMC 和 Cochrane 中央数据库中进行了系统检索。所有符合纳入标准的文章均纳入定性分析。最终定性分析共纳入 8 项观察性研究。使用纽卡斯尔-渥太华量表（NOS）进行质量评估，平均得分为 7.5±1.06，表明研究质量为中等到高度。3 项回顾性队列研究报告称死亡率降低，而其他 6 项研究表明 COVID-19 患者接受治疗剂量抗凝治疗并无死亡率获益。接受治疗剂量抗凝治疗的机械通气 COVID-19 患者死亡率略有降低趋势。有 3 项研究报告了接受治疗剂量抗凝治疗的患者发生出血事件和血栓并发症。虽然现在下结论还为时过早，但这项系统评价提请注意目前关于治疗剂量抗凝与 COVID-19 患者死亡率之间关系的证据。
