Abstract
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.
Lingua originale | Inglese |
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pagine (da-a) | 2335-2343 |
Numero di pagine | 9 |
Rivista | Aging clinical and experimental research |
Volume | 33 |
Numero di pubblicazione | 8 |
DOI | |
Stato di pubblicazione | Pubblicato - 2021 |
All Science Journal Classification (ASJC) codes
- Invecchiamento
- Geriatria e Gerontologia
Keywords
- Administration
- Anticoagulants
- COVID-19
- Direct oral anticoagulants
- Hospital Mortality
- Humans
- Italy
- Older patients
- Oral
- Oral anticoagulation
- Prospective Studies
- Retrospective Studies
- SARS-CoV-2
- Vitamin K
- Vitamin k antagonists