European Primary Care Cardiovascular Society

Relation between anticoagulation use and mortality in hospitalized COVID-19 patients

Association of Treatment Dose Anticoagulation with In-Hospital Survival Among Hospitalized Patients with COVID-19

Literature - Paranjpe I, Fuster V, Lala A, et al. - J Am Coll Cardiol 2020, doi: https://doi.org/10.1016/j.jacc.2020.05.001

Introduction and methods

High incidence of thrombotic complications have been observed in hospitalized COVID-19 patients [1,2]. There are anecdotal observations of improved outcomes with systemic anticoagulation, but the role of anticoagulation in management of COVID-19 patients is not known [3,4]. Therefore, this study examined the association between use of in-hospital anticoagulation and survival in a large cohort of COVID-19 patients.

Of 2773 hospitalized COVID-19 patients within the Mount Sinai Health System in New York City between March 14 and April 11, 2020, 786 (28%) patients received anticoagulation during hospital stay.

Main results

Patients treated with anticoagulation had a in-hospital mortality rate of 22.5% with a median survival of 21 days, compared to 22.8% and median survival of 14 days in patients who did not receive anticoagulation.

Conclusion

The authors conclude that these findings suggest that systemic anticoagulation may be associated with improved outcomes in patients hospitalized with COVID-19. They note, however, that benefit of systemic anticoagulation needs to weighted against risk of bleeding. The association between administration of anticoagulation and mechanical ventilation likely reflects more severe clinical presentation of patients who require anticoagulation.

References

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