4.5 Article

Prior use of therapeutic anticoagulation does not protect against COVID-19 related clinical outcomes in hospitalized patients: A propensity score-matched cohort study

Journal

BRITISH JOURNAL OF CLINICAL PHARMACOLOGY
Volume 87, Issue 12, Pages 4839-4847

Publisher

WILEY
DOI: 10.1111/bcp.14877

Keywords

anticoagulation; corona virus disease 2019; direct oral anticoagulants; pulmonary embolism; thromboprophylaxis; thrombosis; vitamin K antagonist

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This study found that prior use of therapeutic anticoagulation is not associated with improved clinical outcomes in hospitalized COVID-19 patients.
The hypercoagulable state observed in COVID-19 could be responsible for morbidity and mortality. In this retrospective study we investigated whether therapeutic anticoagulation prior to infection has a beneficial effect in hospitalized COVID-19 patients. This study included 1154 COVID-19 patients admitted to 6 hospitals in the Netherlands between March and May 2020. We applied 1:3 propensity score matching to evaluate the association between prior therapeutic anticoagulation use and clinical outcome, with in hospital mortality as primary endpoint. In total, 190 (16%) patients used therapeutic anticoagulation prior to admission. In the propensity score matched analyses, we observed no associations between prior use of therapeutic anticoagulation and overall mortality (risk ratio 1.02 [95% confidence interval; 0.80-1.30]) or length of hospital stay (7.0 [4-12] vs. 7.0 [4-12] days, P = .69), although we observed a lower risk of pulmonary embolism (0.19 [0.05-0.80]). This study shows that prior use of therapeutic anticoagulation is not associated with improved clinical outcome in hospitalized COVID-19 patients.

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