Anticoagulation therapy does not improve survival in COVID 19 patients: Study
Italy: Treatment of the general population having coronavirus disease 2019 with anticoagulation therapy is not associated with better survival but with higher bleeding risk, finds a recent study. However, anticoagulation therapy yielded better results in terms of lower mortality in patients admitted with respiratory failure requiring invasive ventilation.
The results of the study are published in the journal Critical Care Medicine.
No standard therapy is currently recommended for COVID-19 patients in the absence of solid clinical data. To fill this knowledge gap, Francesco Santoro, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy, and colleagues aimed to evaluate the efficacy of anticoagulation in coronavirus disease 2019 hospitalized patients and its impact on survival.
The study included 5,838 consecutive hospitalized patients with coronavirus disease 2019 from the Multicenter international prospective registry (Health Outcome Predictive Evaluation for Corona Virus Disease 2019). The researcher obtained information on each patient's anticoagulation therapy, including prophylactic and therapeutic regimens.
Key findings of the study include:
- 94% of the patients did not receive any anticoagulation before hospitalization.
- 44% during hospitalization received anticoagulation therapy and it was not associated with a better survival rate (81% vs 81%) but with a higher risk of bleeding (2.7% vs 1.8%).
- Among patients admitted with respiratory failure (49%, "http://webservices.ovid.com/mrws/1.0" = 2,859, including 391 and 583 patients requiring invasive and noninvasive ventilation, respectively), anticoagulation started during hospitalization was associated with lower mortality rates (32% vs 42%) and nonsignificant higher risk of bleeding (3.4% vs 2.7%).
- Anticoagulation therapy was associated with lower mortality rates in patients treated with invasive ventilation (53% vs 64%) without increased rates of bleeding (9% vs 8%) but not in those with noninvasive ventilation (35% vs 38%).
- At multivariate Cox' analysis mortality relative risk with anticoagulation was 0.58 in patients admitted with respiratory failure, 0.50 in those requiring invasive ventilation, 0.72 in noninvasive ventilation.
"Anticoagulation therapy in general population with coronavirus disease 2019 was not associated with better survival rates but with higher bleeding risk," wrote the authors. "Better results were observed in patients admitted with respiratory failure and requiring invasive ventilation."
Reference:
The study titled, "Anticoagulation Therapy in Patients With Coronavirus Disease 2019: Results From a Multicenter International Prospective Registry (Health Outcome Predictive Evaluation for Corona Virus Disease 2019 [HOPE-COVID19])," is published in the journal Critical Care Medicine.
DOI: https://journals.lww.com/ccmjournal/fulltext/2021/06000/anticoagulation_therapy_in_patients_with.21.aspx
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