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Inverse Probability of Treatment Weighting Propensity Score using the Military Health System Data Repository and National Death Index
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Inverse Probability of Treatment Weighting Propensity Score using the Military Health System Data Repository and National Death Index

Published on: January 8, 2020

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Intermediate-dose anticoagulation, aspirin, and in-hospital mortality in COVID-19: a propensity score-matched

Matthew L Meizlish1, George Goshua2, Yiwen Liu3

  • 1Yale School of Medicine, New Haven, CT.

Medrxiv : the Preprint Server for Health Sciences
|January 20, 2021
PubMed

Insights

Intermediate-dose anticoagulation and aspirin significantly reduced in-hospital deaths for COVID-19 patients. This study highlights the benefits of these antithrombotic therapies in reducing mortality for hospitalized COVID-19 cases.

Area of Science:

  • Internal Medicine
  • Cardiology
  • Infectious Diseases

Background:

  • Hospitalized COVID-19 patients face high rates of thrombotic complications.
  • The effectiveness of intensive antithrombotic therapy in reducing mortality remains uncertain.

Approach:

  • Two nested cohorts were established from 2785 hospitalized COVID-19 patients: one comparing intermediate- versus prophylactic-dose anticoagulation (N=1624), and another comparing in-hospital aspirin versus no antiplatelet therapy (N=1956).
  • Propensity score matching was used to balance covariates between treatment groups within each cohort.
  • The primary outcome was the cumulative incidence of in-hospital death.

Key Points:

  • In the anticoagulation cohort (N=382), intermediate-dose anticoagulation was associated with a significantly lower incidence of in-hospital death compared to prophylactic-dose (HR 0.518).
  • In the aspirin cohort (N=638), in-hospital aspirin was associated with a significantly lower incidence of in-hospital death compared to no antiplatelet therapy (HR 0.522).

Conclusions:

  • Intermediate-dose anticoagulation and aspirin are associated with reduced in-hospital mortality in COVID-19 patients.
  • These findings support the use of these antithrombotic strategies in managing hospitalized COVID-19 patients to improve survival outcomes.
Abstract

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