Taha Amro, Badu Irisha, Sandhyavenu Harigopal, Victor Varun, Duhan Sanchit, Atti Lalitsiri, Qureshi Hasham Masood, Goni Thatiana Schulze, Keisham Bijeta, Sandhya Venu Vasantha, Thyagaturu Harshith, Gonuguntla Karthik, Ullah Waqas, Deshwal Himanshu, Balla Sudarshan
Department of Internal Medicine, Weiss Memorial Hospital, Chicago, IL, USA.
Department of Internal Medicine, Onslow Memorial Hospital, Jacksonville, NC, USA.
Expert Rev Cardiovasc Ther. 2023 Jul-Dec;21(8):601-608. doi: 10.1080/14779072.2023.2234282. Epub 2023 Jul 10.
The role of oral anticoagulation during the COVID-19 pandemic has been debated widely. We studied the clinical outcomes of COVID-19 hospitalizations in patients who were on long-term anticoagulation.
The Nationwide Inpatient Sample (NIS) database from 2020 was queried to identify COVID-19 patients with and without long-term anticoagulation. Multivariate regression analysis was used to calculate the adjusted odds ratio (aOR) of in-hospital outcomes.
Of 1,060,925 primary COVID-19 hospitalizations, 102,560 (9.6%) were on long-term anticoagulation. On adjusted analysis, COVID-19 patients on anticoagulation had significantly lower odds of in-hospital mortality (aOR 0.61, 95% CI 0.58-0.64, < 0.001), acute myocardial infarction (aOR 0.72, 95% CI 0.63-0.83, < 0.001), stroke (aOR 0.79, 95% CI 0.66-0.95, < 0.013), ICU admissions, (aOR 0.53, 95% CI 0.49-0.57, < 0.001) and higher odds of acute pulmonary embolism (aOR 1.47, 95% CI 1.34-1.61, < 0.001), acute deep vein thrombosis (aOR 1.17, 95% CI 1.05-1.31, = 0.005) compared to COVID-19 patients who were not on anticoagulation.
Compared to COVID-19 patients not on long-term anticoagulation, we observed lower in-hospital mortality, stroke and acute myocardial infarction in COVID-19 patients on long-term anticoagulation. Prospective studies are needed for optimal anticoagulation strategies in hospitalized patients.
在新型冠状病毒肺炎（COVID-19）大流行期间，口服抗凝药的作用一直存在广泛争议。我们研究了长期接受抗凝治疗的COVID-19住院患者的临床结局。
查询2020年全国住院患者样本（NIS）数据库，以识别接受和未接受长期抗凝治疗的COVID-19患者。采用多因素回归分析计算住院结局的调整比值比（aOR）。
在1,060,925例原发性COVID-19住院患者中，102,560例（9.6%）接受长期抗凝治疗。经调整分析，与未接受抗凝治疗的COVID-19患者相比，接受抗凝治疗的COVID-19患者住院死亡率（aOR 0.61，95%可信区间[CI] 0.58-0.64，P<0.001）、急性心肌梗死（aOR 0.72，95% CI 0.63-0.83，P<0.001）、中风（aOR 0.79，95% CI 0.66-0.95，P<0.013）、入住重症监护病房（ICU）（aOR 0.53，95% CI 0.49-0.57，P<0.001）的几率显著降低，而急性肺栓塞（aOR 1.47，95% CI 1.34-1.61，P<0.001）、急性深静脉血栓形成（aOR 1.17，95% CI 1.05-1.31，P=0.005）的几率更高。
与未接受长期抗凝治疗的COVID-19患者相比，我们观察到接受长期抗凝治疗的COVID-19患者住院死亡率、中风和急性心肌梗死较低。需要进行前瞻性研究以确定住院患者的最佳抗凝策略。
