Department of Geriatric Medicine, Le Mans Hospital, F-72037 Le Mans, France.
Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity, University Hospital, F-49933 Angers, France.
Nutrients. 2020 Dec 24;13(1):39. doi: 10.3390/nu13010039.
Vitamin K concentrations are inversely associated with the clinical severity of COVID-19. The objective of this cohort study was to determine whether the regular use of vitamin K antagonist (VKA) prior to COVID-19 was associated with short-term mortality in frail older adults hospitalized for COVID-19.
Eighty-two patients consecutively hospitalized for COVID-19 in a geriatric acute care unit were included. The association of the regular use of VKA prior to COVID-19 with survival after 7 days of COVID-19 was examined using a propensity-score-weighted Cox proportional-hazards model accounting for age, sex, severe undernutrition, diabetes mellitus, hypertension, prior myocardial infarction, congestive heart failure, prior stroke and/or transient ischemic attack, CHA2DS2-VASc score, HAS-BLED score, and eGFR.
Among 82 patients (mean ± SD age 88.8 ± 4.5 years; 48% women), 73 survived COVID-19 at day 7 while 9 died. There was no between-group difference at baseline, despite a trend for more frequent use of VKA in those who did not survive on day 7 (33.3% versus 8.2%, = 0.056). While considering "using no VKA" as the reference (hazard ratio (HR) = 1), the HR for 7-day mortality in those regularly using VKA was 5.68 [95% CI: 1.17; 27.53]. Consistently, COVID-19 patients using VKA on a regular basis had shorter survival times than the others ( = 0.031).
Regular use of VKA was associated with increased mortality at day 7 in hospitalized frail elderly patients with COVID-19.
维生素 K 浓度与 COVID-19 的临床严重程度呈负相关。本队列研究的目的是确定 COVID-19 之前是否经常使用维生素 K 拮抗剂 (VKA) 与因 COVID-19 住院的体弱老年人的短期死亡率相关。
连续纳入 82 例因 COVID-19 入住老年急性护理病房的患者。使用倾向评分加权 Cox 比例风险模型，根据年龄、性别、严重营养不良、糖尿病、高血压、既往心肌梗死、充血性心力衰竭、既往中风和/或短暂性脑缺血发作、CHA2DS2-VASc 评分、HAS-BLED 评分和 eGFR，检查 COVID-19 之前经常使用 VKA 与 COVID-19 后 7 天的生存关系。
在 82 例患者中（平均年龄 ± 标准差为 88.8 ± 4.5 岁；48%为女性），73 例在第 7 天存活 COVID-19，9 例死亡。尽管第 7 天未存活患者更频繁地使用 VKA（33.3%比 8.2%， = 0.056），但两组间无基线差异。考虑“未使用 VKA”为参考（风险比 (HR) = 1），定期使用 VKA 的患者 7 天死亡率的 HR 为 5.68 [95%CI：1.17；27.53]。同样，定期使用 VKA 的 COVID-19 患者的存活时间短于其他患者（ = 0.031）。
在因 COVID-19 住院的体弱老年患者中，经常使用 VKA 与第 7 天的死亡率增加相关。
