In a single-city, retrospective study, anticoagulation is associated with lower in-hospital mortality among COVID-19 patients.
Researchers retrospectively examined patterns of anticoagulation and effects of these treatments in nearly 4400 adults admitted to New York City hospitals with COVID-19. Of the patients, 45% received prophylactic anticoagulation, 21% received therapeutic anticoagulation, and the remainder received none. Overall, 24% of the patients died in the hospital. After multivariable adjustment, prophylactic and therapeutic treatment were each associated with roughly a 50% reduction in mortality, relative to no anticoagulation. Rates of major bleeding were low (2%–3%). In addition, of 26 autopsies performed, thromboembolic disease was found in 42%; most of these patients had not received therapeutic anticoagulation.
— Adapted from a Physician's First Watch article, published August 26, 2020
Reviewing Author
DisclosuresConsultant/Advisory BoardUnited Healthcare; Element Science; Eyedentifeye, F-Prime
EquityHugo Health; Refactor Health; Element Science
Grant/Research SupportPfizer; Agency for Healthcare Research and Quality; Janssen Research and Development, National Institute of Biomedical Imaging and Engineering; National Heart, Lung, and Blood Institute; Centers for Disease Control and Prevention; National Cancer Institute; American Heart Association
DisclosuresConsultant/Advisory BoardUnited Healthcare; Element Science; Eyedentifeye, F-Prime
EquityHugo Health; Refactor Health; Element Science
Grant/Research SupportPfizer; Agency for Healthcare Research and Quality; Janssen Research and Development, National Institute of Biomedical Imaging and Engineering; National Heart, Lung, and Blood Institute; Centers for Disease Control and Prevention; National Cancer Institute; American Heart Association
Citation(s):
Nadkarni GN et al. Anticoagulation, mortality, bleeding and pathology among patients hospitalized with COVID-19: A single health system study. J Am Coll Cardiol 2020 Aug 24; [e-pub]. (https://doi.org/10.1016/j.jacc.2020.08.041)
Comment
This is a provocative observational study and supports the need for trials to test the hypothesis that both prophylactic and therapeutic anticoagulation are associated with fewer deaths in hospitalized COVID-19 patients.