Ram Muskaan Doulat, Umer Muhammed, Trada Ishani Jayantibhai, Khan Salman J, Imran Laiba, Rehan Tayyaba, Hassan Warda, Zafar Faiqa, Razak Sufyan, Laeeq Tooba, Aijaz Parisa, Majid Zainab
Internal Medicine, Dow University of Health Sciences, Karachi, PAK.
Internal Medicine, American University of Barbados, Bridgetown, BRB.
Cureus. 2023 Sep 22;15(9):e45749. doi: 10.7759/cureus.45749. eCollection 2023 Sep.
The coronavirus disease 2019 (COVID-19) is associated with prolonged prothrombin time (PT), active partial thromboplastin time (aPTT), and increased D-dimer levels. Therefore, we aim to investigate if anticoagulants (AC) and antiplatelet (AP) therapy play a role in mitigating COVID-19 and its associated thrombosis along with its effect on the mortality rate, the need for mechanical ventilation, and the risk of hospital admission. Electronic databases were searched from their inception to July 19, 2022. The studies were divided into two groups: Group A (any dose of AC/AP versus no AC/AP) and Group B (therapeutic dose of AC (tAC)/AP versus prophylactic dose of AC (pAC)/AP). Review Manager (RevMan) version 5.4.1 (The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, Denmark) was used for all statistical analyses. Adjusted data ratios were extracted from all included studies and pooled using the random effects model. A total of 33 studies were taken for the analysis of two groups (Group A: 285,065 COVID-19-positive patients, Group B: 2,421 COVID-19-positive patients). Overall analysis in Group A showed that the AC/AP group had a low risk of mortality in COVID-19 patients compared to the control group (risk ratio (RR): 0.77, 95% confidence interval (CI): 0.69-0.86). There was no significant difference in the need for mechanical ventilation (RR: 0.80, 95% CI: 0.60-1.08) and hospital admission (RR: 1.12, 95% CI: 0.78-1.59) between the AC/AP and no AC/AP group. Alongside, in Group B, tAC/AP did not demonstrate a significant decrease in mortality as compared to pAC/AP (RR: 0.62, 95% CI: 0.37-1.06). Treatment with AC and AP drugs can significantly decrease the mortality rate in COVID-19-infected patients, while AC also significantly reduces the need for mechanical ventilation.
2019冠状病毒病(COVID-19)与凝血酶原时间(PT)延长、活化部分凝血活酶时间(aPTT)延长及D-二聚体水平升高相关。因此,我们旨在研究抗凝剂(AC)和抗血小板药物(AP)治疗在减轻COVID-19及其相关血栓形成方面是否起作用,以及其对死亡率、机械通气需求和住院风险的影响。检索了从数据库建立至2022年7月19日的电子数据库。研究分为两组:A组(任何剂量的AC/AP与不使用AC/AP)和B组(治疗剂量的AC(tAC)/AP与预防性剂量的AC(pAC)/AP)。所有统计分析均使用Review Manager(RevMan)5.4.1版本(北欧 Cochrane中心,Cochrane协作网,丹麦哥本哈根)。从所有纳入研究中提取调整后的数据比率,并使用随机效应模型进行汇总。共纳入33项研究用于两组分析(A组:285,065例COVID-19阳性患者,B组:2,421例COVID-19阳性患者)。A组的总体分析显示,与对照组相比,AC/AP组的COVID-19患者死亡率较低(风险比(RR):0.77,95%置信区间(CI):0.69-0.86)。AC/AP组与不使用AC/AP组在机械通气需求(RR:0.80,95%CI:0.60-1.08)和住院情况(RR:1.12,95%CI:0.78-1.59)方面无显著差异。此外,在B组中,与pAC/AP相比,tAC/AP在死亡率方面未显示出显著降低(RR:0.62,95%CI:0.37-1.06)。使用AC和AP药物治疗可显著降低COVID-19感染患者的死亡率,同时AC还可显著降低机械通气需求。