新冠病毒疾病（COVID-19）患者就诊前使用口服抗凝剂对死亡率的影响：一项荟萃分析。
The effect of oral anticoagulant use before visit for patients with COVID-19 on mortality: A meta-analysis.
作者信息
Ghea Cornelia, Wardhana Ardyan, Nugroho Alfredo, Assilmi Fika Humaeda
机构信息
Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.
Department of Clinical Medicine, Faculty of Medicine, Universitas Surabaya, Surabaya, Indonesia.
出版信息
Tzu Chi Med J. 2022 Nov 2;35(3):226-230. doi: 10.4103/tcmj.tcmj_199_22. eCollection 2023 Jul-Sep.
OBJECTIVES
Anticoagulants have been used as therapeutic or prophylactic agents in COVID-19 and seem to be more beneficial. However, the advantage of oral anticoagulant (OAC) consumption before visit in lowering mortality in COVID-19 patients remains debatable. This meta-analysis aimed to evaluate the effect of OAC use before visit on mortality using the hazard ratio (HR) to estimate the effect of time-to-event endpoints.
MATERIALS AND METHODS
We conducted a literature search in the PubMed and ProQuest databases for any studies comparing groups consuming OAC to no-OAC before visit for mortality in patients with COVID-19. We calculated the overall HRs and their variances across the studies using the random-effects model to obtain pooled estimates.
RESULTS
We included 12 studies which had sample sizes ranging from 70 to 459,402 patients. A meta-analysis comparing OAC therapy and non-OAC consumption in COVID-19 patients before visit revealed no decrease in all-cause mortality (HR = 0.92, 95% confidence interval [CI]: 0.83-1.02, = 0.12; = 68%). However, subgroup analysis of laboratory-confirmed populations revealed that OAC use before visit had a beneficial effect on mortality (HR = 0.84, 95% CI: 0.73-0.98, = 0.02; = 56%).
CONCLUSION
The use of OAC before visit had no beneficial effect on all-cause mortality in COVID-19 patients.
目的
抗凝剂已被用作治疗或预防新冠病毒疾病（COVID-19）的药物，且似乎更有益处。然而，就诊前服用口服抗凝剂（OAC）对降低COVID-19患者死亡率的益处仍存在争议。本荟萃分析旨在使用风险比（HR）评估就诊前使用OAC对死亡率的影响，以估计事件发生时间终点的效应。
材料与方法
我们在PubMed和ProQuest数据库中进行文献检索，查找比较COVID-19患者就诊前服用OAC组与未服用OAC组死亡率的任何研究。我们使用随机效应模型计算各研究的总体HR及其方差，以获得合并估计值。
结果
我们纳入了12项研究，样本量从70至459,402名患者不等。一项对COVID-19患者就诊前OAC治疗与未服用OAC的荟萃分析显示，全因死亡率没有降低（HR = 0.92，95%置信区间[CI]：0.83 - 1.02，P = 0.12；I² = 68%）。然而，实验室确诊人群的亚组分析显示，就诊前使用OAC对死亡率有有益影响（HR = 0.84，95% CI：0.73 - 0.98，P = 0.02；I² = 56%）。
结论
就诊前使用OAC对COVID-19患者的全因死亡率没有有益影响。
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