Does chronic oral anticoagulation reduce in-hospital mortality among COVID-19 older patients?

Marcello Covino, Giuseppe De Matteis, Davide Della Polla, Maria Livia Burzo, Marco Maria Pascale, Marco Santoro, Raimondo De Cristofaro, Antonio Gasbarrini, Erica De Candia, Francesco Franceschi

Research output: Contribution to journalArticle


Background: Patients hospitalized with COVID-19 experienced an increased risk of venous thromboembolism. Aims: To evaluate the effect of chronic oral anticoagulation (OAC) therapy, both with vitamin K antagonists (VKAs) or direct oral anticoagulants (DOACs), on prognosis of COVID-19 older patients. Methods: Single-center prospective study conducted in the Emergency Department (ED) of a teaching hospital, referral center for COVID-19 in central Italy. We evaluated all the patients ≥ 65 years, consecutively admitted to our ED for confirmed COVID-19. We compared the clinical outcome of those who were on chronic OAC at ED admission with those who did not, using a propensity score matched paired cohort of controls. The primary study endpoint was all-cause in-hospital death. Patients were matched for age, sex, clinical comorbidities, and clinical severity at presentation (based on NEWS ≥ 6). Study parameters were assessed for association to all-cause in-hospital death by a multivariate Cox regression analysis to identify independent risk factor for survival. Results: Although overall mortality was slightly higher for anticoagulated patients compared to controls (63.3% vs 43.5%, p = 0.012), the multivariate adjusted hazard ratio (HR) for death was not significant (HR = 1.56 [0.78–3.12]; p = 0.208). Both DOACs (HR 1.46 [0.73–2.92]; p = 0.283) and VKAs (HR 1.14 [0.48–2.73]; p = 0.761) alone did not affect overall survival in our cohort. Conclusions: Among older patients hospitalized for COVID-19, chronic OAC therapy was not associated with a reduced risk of in-hospital death. Moreover, our data suggest similar outcome both for patients on VKAs or in patients on DOACs.
Original languageEnglish
Pages (from-to)2335-2343
Number of pages9
JournalAging clinical and experimental research
Publication statusPublished - 2021


  • Administration, Oral
  • Anticoagulants
  • COVID-19
  • Direct oral anticoagulants
  • Hospital Mortality
  • Humans
  • Italy
  • Older patients
  • Oral anticoagulation
  • Prospective Studies
  • Retrospective Studies
  • SARS-CoV-2
  • Vitamin K
  • Vitamin k antagonists


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