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

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.