Azimi Pirsaraei Vanoushe, Jozpanahi Manizhe, Kamali Koorosh, Hamzeloo Leila, Saeid Seyedeh Pegah
Research Committee/General Medicine, Zanjan University of Medical Sciences, Zanjan, IRN.
Department of Infectious Diseases, Valiasr Hospital, Zanjan University of Medical Sciences, Zanjan, IRN.
Cureus. 2024 Aug 13;16(8):e66798. doi: 10.7759/cureus.66798. eCollection 2024 Aug.
Background The mortality and morbidity of thrombotic events in patients with coronavirus disease 2019 (COVID-19) are increasing worldwide. The clinical impact of prophylactic anticoagulation regimens among these patients in Iran remains unclear. This study aimed to evaluate the use of prophylactic anticoagulants and outcomes among COVID-19 patients admitted to a tertiary referral hospital. Methodology Patients diagnosed with COVID-19 and hospitalized between March 20 and June 20, 2020, were included in this longitudinal study after obtaining informed consent. Demographic and clinical data were collected from the hospital information system and medical records. Outcomes during this period were also evaluated. The data were entered into the preparation checklist and analyzed using SPSS version 24 software (IBM Corp., Armonk, NY, USA), employing chi-square, Fisher's exact, and Mann-Whitney U tests. Results Of the 831 enrolled patients, 51.9% were female, and 10.6% needed to be admitted to the intensive care unit (ICU). The mean age of the patients was 57.16 ± 17.32 years, and the mortality rate was estimated to be 9.4%. Mortality rates were significantly higher at older ages, in men, patients with ICU admission, severe pulmonary involvement, malignancy, airway obstruction, ischemic heart disease, and previous cerebrovascular accidents. ICU admission and mortality were statistically significantly higher in those who received concurrent prophylactic anticoagulants and aspirin than in other individuals. Conclusions Our study demonstrated that administering prophylactic aspirin with or without anticoagulant agents in COVID-19 patients did not reduce mortality rates or ICU transfers. However, it is worth noting that anticoagulant prescription was associated with a decrease in ICU admissions, which could potentially alleviate the significantly higher mortality rates observed among ICU patients in this study. Further research is needed to explore the potential benefits of anticoagulants in COVID-19 treatment.
2019冠状病毒病（COVID-19）患者血栓形成事件的死亡率和发病率在全球范围内呈上升趋势。预防性抗凝方案对伊朗这些患者的临床影响仍不明确。本研究旨在评估一家三级转诊医院收治的COVID-19患者预防性抗凝剂的使用情况及预后。
2020年3月20日至6月20日期间确诊为COVID-19并住院的患者在获得知情同意后纳入本纵向研究。从医院信息系统和病历中收集人口统计学和临床数据。在此期间的预后也进行了评估。数据输入准备清单，并使用SPSS 24版软件（美国纽约州阿蒙克市IBM公司）进行分析，采用卡方检验、Fisher精确检验和Mann-Whitney U检验。
在831名入组患者中，51.9%为女性，10.6%需要入住重症监护病房（ICU）。患者的平均年龄为57.16±17.32岁，死亡率估计为9.4%。年龄较大者、男性、入住ICU的患者、严重肺部受累患者、恶性肿瘤患者、气道阻塞患者、缺血性心脏病患者和既往有脑血管意外的患者死亡率显著更高。同时接受预防性抗凝剂和阿司匹林治疗的患者入住ICU和死亡率在统计学上显著高于其他患者。
我们的研究表明，在COVID-19患者中使用或不使用抗凝剂给予预防性阿司匹林并不能降低死亡率或减少转入ICU的情况。然而，值得注意的是，抗凝剂处方与入住ICU人数的减少有关，这可能潜在地缓解了本研究中ICU患者中观察到的显著更高的死亡率。需要进一步研究以探索抗凝剂在COVID-19治疗中的潜在益处。
