Hernandez Inmaculada, Gabriel Nico, He Meiqi, Guo Jingchuan, Tadrous Mina, Suda Katie J, Magnani Jared W
Division of Clinical Pharmacy, University of California, San Diego, Skaggs School of Pharmacy and Pharmaceutical Sciences, La Jolla, CA, United States of America.
Department of Pharmaceutical Outcomes and Policy, University of Florida College of Pharmacy, Gainesville, FL, United States of America.
Am Heart J Plus. 2022 Jan;13:100096. doi: 10.1016/j.ahjo.2022.100096. Epub 2022 Feb 4.
Atrial fibrillation (AF) is strongly associated with clinical adversity, including increased hospitalization and bleeding and stroke events. We examined the effect of the SARS-2 Coronavirus 2019 (COVID-19) pandemic on such events in individuals with AF receiving oral anticoagulation.
We employed medical and pharmacy claims spanning 2018-2020 from a nationally representative U.S. database (IQVIA Longitudinal Prescription, Medical Claims, and Institutional Claims). We selected individuals receiving oral anticoagulation in 2018 for AF and followed them from 1/1/2019-7/8/2020 for clinical events. We constructed interrupted time-series analyses across 30-day intervals with Poisson regression models to determine the effect of the COVID-19 pandemic on clinical events.
The dataset included 1,439,145 individuals (half with age ≥75 years; 47.6% women) receiving oral anticoagulation. We determined a 19% decrease in emergency room visits following the pandemic declaration and 8% decrease in inpatient admissions. In contrast admissions for stroke and bleeding were not affected by the declaration of the pandemic.
These results describe the temporal effect of the COVID-19 pandemic on clinical adversity - hospitalizations, strokes, and bleeding events - in individuals receiving oral anticoagulation for AF. Our analysis quantifies the decrease in clinical adversity accompanying COVID-19 in a large, highly representative U.S. health claims database.
心房颤动（AF）与临床不良事件密切相关，包括住院率增加、出血和中风事件。我们研究了2019年严重急性呼吸综合征冠状病毒2（COVID-19）大流行对接受口服抗凝治疗的房颤患者此类事件的影响。
我们使用了来自具有全国代表性的美国数据库（IQVIA纵向处方、医疗索赔和机构索赔）的2018 - 2020年医疗和药房索赔数据。我们选择了2018年接受口服抗凝治疗的房颤患者，并在2019年1月1日至2020年7月8日期间对他们进行临床事件跟踪。我们使用泊松回归模型在30天间隔内构建中断时间序列分析，以确定COVID-19大流行对临床事件的影响。
数据集包括1,439,145名接受口服抗凝治疗的个体（一半年龄≥75岁；47.6%为女性）。我们确定大流行声明发布后急诊就诊次数减少了19%，住院人数减少了8%。相比之下，中风和出血的住院人数不受大流行声明的影响。
这些结果描述了COVID-19大流行对接受口服抗凝治疗的房颤患者临床不良事件（住院、中风和出血事件）的时间效应。我们的分析在一个大型、极具代表性的美国健康索赔数据库中量化了COVID-19伴随的临床不良事件的减少。
