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Anticoagulation in COVID-19: a single-center retrospective study

Sohaib Sanan Roomi1, Maryum Saddique2, Waqas Ullah1

  • 1Jefferson Health-Abington, Abington, PA, USA.

Journal of Community Hospital Internal Medicine Perspectives
|February 8, 2021
PubMed

Insights

Therapeutic anticoagulation in COVID-19 patients significantly reduced in-hospital mortality, intensive care unit (ICU) upgrades, and mechanical ventilation needs. This approach is recommended over prophylactic anticoagulation for COVID-19 unless further trials indicate otherwise.

Area of Science:

  • Internal Medicine
  • Cardiology
  • Critical Care Medicine

Background:

  • COVID-19 is associated with a pro-thrombotic state, leading to microvascular thrombi.
  • The role of therapeutic anticoagulation in managing COVID-19 remains debated with limited evidence.

Purpose of the Study:

  • To investigate the impact of therapeutic anticoagulation on clinical outcomes in hospitalized COVID-19 patients.
  • To determine if therapeutic anticoagulation reduces in-hospital mortality, ICU transfer, mechanical ventilation, and acute renal failure.

Main Methods:

  • A retrospective cohort study involving 176 hospitalized COVID-19 patients.
  • Patients were divided into therapeutic and prophylactic anticoagulation groups.
  • Statistical analyses included independent t-tests and multivariate logistic regression to calculate odds ratios (aOR) and 95% confidence intervals (CI).

Main Results:

  • Therapeutic anticoagulation was associated with significantly lower adjusted odds ratios for in-hospital mortality (aOR 3.05), ICU upgrade (aOR 3.08), and mechanical ventilation (aOR 4.27).
  • No significant difference was observed in the rate of acute renal failure requiring dialysis between the groups (aOR 1.87).
  • Baseline characteristics and comorbidities were similar between the two groups.

Conclusions:

  • Therapeutic anticoagulation significantly reduces in-hospital mortality, ICU admission, and mechanical ventilation in COVID-19 patients.
  • This suggests therapeutic anticoagulation may be preferable to prophylactic anticoagulation for COVID-19 patients.
  • Further randomized controlled trials are needed to confirm these findings.

Keywords:
COVID-19anticoagulationthrombosis

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