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Coronavirus disease 2019 infection in patients with recent cardiac surgery: does chronic anticoagulant therapy have a
Giuseppe Inama1, Claudio Dodi1, Martino Provini1
1Division of Cardiology and Cardiac Rehabilitation, Istituto Figlie di San Camillo, Cremona.
Insights
Patients with COVID-19 undergoing cardiac rehabilitation who were on anticoagulant therapy showed a milder clinical course. This suggests anticoagulants may improve outcomes in these cardiac patients with coronavirus disease 2019.
Area of Science:
- Cardiology
- Infectious Diseases
- Pulmonology
Background:
- COVID-19 poses risks to patients with recent cardiac procedures.
- Cardiac rehabilitation patients are a vulnerable population during the pandemic.
Purpose of the Study:
- To assess the clinical outcomes of COVID-19 in cardiac rehabilitation inpatients.
- To investigate the potential impact of anticoagulant therapy on COVID-19 severity in this cohort.
Main Methods:
- Retrospective study of 35 inpatients (Feb-Mar 2020).
- Divided into COVID-19 positive (n=10) and negative (n=25) groups.
- Analyzed COVID-19 patient characteristics, including anticoagulant use (n=9) versus dual antiplatelet therapy (n=1).
Main Results:
- All COVID-19 patients had interstitial pneumonia on CT scans.
- One patient on dual antiplatelet therapy required mechanical ventilation and died.
- Nine patients on chronic anticoagulant therapy recovered and were discharged.
Conclusions:
- Chronic anticoagulant therapy may be associated with a more favorable clinical course in COVID-19 patients post-cardiac procedure.
- Further prospective research is needed to validate these findings.
Aims:
The aim of this study was to evaluate the clinical course of COVID-19 in patients who had recently undergone a cardiac procedure and were inpatients in a cardiac rehabilitation department.
Methods:
All patients hospitalized from 1 February to 15 March 2020 were included in the study (n = 35; 16 men; mean age 78 years). The overall population was divided into two groups: group 1 included 10 patients who presented with a clinical picture of COVID-19 infection and were isolated, and group 2 included 25 patients who were COVID-19-negative. In group 1, nine patients were on chronic oral anticoagulant therapy and one patient was on acetylsalicylic acid (ASA) and clopidogrel. A chest computed tomography scan revealed interstitial pneumonia in all 10 patients.
Results:
During hospitalization, COVID-19 patients received azithromycin and hydroxychloroquine in addition to their ongoing therapy. Only the patient on ASA with clopidogrel therapy was transferred to the ICU for mechanical ventilation because of worsening respiratory failure, and subsequently died from cardiorespiratory arrest. All other patients on chronic anticoagulant therapy recovered and were discharged.
Conclusion:
Our study suggests that COVID-19 patients on chronic anticoagulant therapy may have a more favorable and less complicated clinical course. Further prospective studies are warranted to confirm this preliminary observation.
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