Samuelsen Per-Jostein, Wettermark Björn, Nyberg Fredrik, Hajiebrahimi Mohammadhossein
Regional Medicines Information and Pharmacovigilance Centre (RELIS), University Hospital of North Norway, Tromso, Norway.
Pharmacoepidemiology, Department of Pharmacy, Uppsala University, Uppsala, Sweden.
Basic Clin Pharmacol Toxicol. 2025 Feb;136(2):e14119. doi: 10.1111/bcpt.14119.
The COVID-19 pandemic may have increased anticoagulant initiation due to the thrombogenic nature of the disease or decreased due to the societal impact of the pandemic. We aimed to study the effect of the COVID-19 pandemic on initiation of anticoagulants in Sweden. We conducted a single interrupted time series analysis on the monthly cumulative incidence of nonvitamin K antagonist oral anticoagulants (NOAC), warfarin, or heparins, before and after March 2020, using SCIFI-PEARL dataset. For anticoagulants in total, there were no statistically significant changes or differences in the trends of initiation after the start of the pandemic. There was a slight numerical decrease in initiation after the onset of the pandemic, particularly for NOACs. For individuals aged ≥ 65 years, however, the immediate decrease in initiation was considerable for NOACs. The prepandemic declining trend of warfarin initiation seemed to attenuate, that is, became less negative, after March 2020. We did not find any profound effect of the COVID-19 pandemic on the initiation of anticoagulants in total. However, among individuals aged ≥ 65 years, a notable immediate decrease in initiation of NOACs was observed. Furthermore, the onset of the pandemic may have attenuated the downward temporal trend in initiation of warfarin use.
由于新冠病毒疾病具有血栓形成倾向，新冠疫情可能增加了抗凝剂的起始使用，也可能因疫情的社会影响而减少了抗凝剂的起始使用。我们旨在研究新冠疫情对瑞典抗凝剂起始使用的影响。我们利用SCIFI-PEARL数据集，对2020年3月前后非维生素K拮抗剂口服抗凝剂（NOAC）、华法林或肝素的月度累积发病率进行了单中断时间序列分析。对于总体抗凝剂而言，疫情开始后起始使用趋势没有统计学上的显著变化或差异。疫情开始后起始使用略有下降，尤其是NOAC。然而，对于年龄≥65岁的个体，NOAC起始使用的立即下降相当显著。2020年3月后，华法林起始使用的疫情前下降趋势似乎有所减弱，即负性减弱。我们没有发现新冠疫情对总体抗凝剂起始使用有任何深远影响。然而，在年龄≥65岁的个体中，观察到NOAC起始使用明显立即下降。此外，疫情的发生可能减弱了华法林使用起始的下降时间趋势。
