Nawaz Haroon, Choudhry Ayesha, Morse William J, Zarnowski Oskar, Patel Harsh, Amin Harshad
Internal Medicine, Westside Regional Medical Center, Plantation, USA.
Research, Fatima Jinnah Medical University, Lahore, PAK.
Cureus. 2022 Mar 22;14(3):e23382. doi: 10.7759/cureus.23382. eCollection 2022 Mar.
Background As of December 2021, the coronavirus disease 2019 (COVID-19) pandemic has resulted in the deaths of over 5 million people. It is known that infection with this virus causes a state of hypercoagulability. Because of this, there has been considerable debate on whether or not patients should be placed on anticoagulation prophylaxis/therapy. The goal of our project was to shed light on this topic by examining the effects of preexisting anticoagulation therapy in COVID-19 patients on disease severity (measured by blood clot readmissions, transfusion counts, and length of hospital stay). In this retrospective cohort study, we conducted an analysis based on data from 30,076 COVID-19-positive patients' electronic medical records. Materials and methods This is a retrospective cohort study. Patients included in this study were identified from the HCA Healthcare corporate database. Registry data was sourced from HCA East Florida hospitals. All patients included in this study were COVID-19 positive via polymerase chain reaction (PCR) or rapid antigen testing on admission and over age 18. A total of 30,076 patients were included in this study with hospital admission dates from March 1, 2020 to June 30, 2021. The analysis examined the relationship between age, sex, blood clot history, and most importantly current anticoagulation status on COVID-19 disease severity (through blood clot readmissions, length of stay, and transfusion count). Blood clot readmissions were analyzed with a logistic regression model while the length of hospital stay and transfusion count were analyzed with a linear regression model. Results Our analysis revealed that the odds of experiencing a blood clot readmission is 2.017 times more likely in patients already on anticoagulation therapy compared to those who were not (p = 0.0024). We also found that patients on anticoagulation therapy had a hospital stay of 6.90 days longer on average than patients not on anticoagulation therapy (p < 0.0001). Finally, patients on anticoagulation therapy had, on average, 0.20 more blood transfusions than patients not on anticoagulation therapy (p < 0.001). Conclusion While these findings may be affected by the underlying conditions of those on preexisting anticoagulation therapy, they provide valuable insight into the debate on whether COVID-19-positive patients should be anticoagulated on admission to a hospital.
背景 截至2021年12月，2019冠状病毒病（COVID-19）大流行已导致500多万人死亡。众所周知，感染这种病毒会导致高凝状态。因此，对于患者是否应接受抗凝预防/治疗一直存在相当大的争议。我们项目的目标是通过研究COVID-19患者先前的抗凝治疗对疾病严重程度（通过血栓再入院率、输血次数和住院时间来衡量）的影响，来阐明这一主题。在这项回顾性队列研究中，我们基于30076例COVID-19阳性患者的电子病历数据进行了分析。
材料和方法 这是一项回顾性队列研究。本研究纳入的患者是从HCA医疗保健公司数据库中识别出来的。登记数据来自HCA东佛罗里达医院。本研究纳入的所有患者入院时经聚合酶链反应（PCR）或快速抗原检测确诊为COVID-19阳性，且年龄超过18岁。本研究共纳入30076例患者，入院日期为2020年3月1日至2021年6月30日。该分析研究了年龄性别、血栓病史，以及最重要的当前抗凝状态与COVID-19疾病严重程度（通过血栓再入院率、住院时间和输血次数）之间的关系。血栓再入院率采用逻辑回归模型分析，住院时间和输血次数采用线性回归模型分析。
结果 我们的分析显示，与未接受抗凝治疗的患者相比，已接受抗凝治疗的患者发生血栓再入院的几率高出2.017倍（p = 0.0024）。我们还发现，接受抗凝治疗的患者平均住院时间比未接受抗凝治疗的患者长6.90天（p < 0.000）。最后，接受抗凝治疗的患者平均输血次数比未接受抗凝治疗的患者多0.20次（p < 0.001）。
结论 虽然这些发现可能受到先前接受抗凝治疗患者潜在病情的影响，但它们为关于COVID-19阳性患者入院时是否应进行抗凝治疗的争论提供了有价值的见解。
