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[Effect of anticoagulant therapy on the course of COVID-19 in comorbid patients]
T A Ruzhentsova1, D A Khavkina2, P V Chukhliaev2
1FSBI Gabrichevsky research institute for epidemiology and microbiology of the Surveillance of Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor).
Insights
Novel oral anticoagulants (NOACs) significantly reduced severe outcomes in COVID-19 patients. Continued NOAC therapy is safe and effective for managing coronavirus infection in comorbid patients.
Area of Science:
- Internal Medicine
- Cardiology
- Infectious Diseases
Background:
- COVID-19 pathogenesis is significantly influenced by hemorheological disorders.
- Chronic cardiovascular diseases increase the risk of severe COVID-19 and mortality.
- Understanding drug interactions in comorbid patients is crucial for effective COVID-19 management.
Purpose of the Study:
- To evaluate the impact of coagulation activity on COVID-19 course.
- To justify the management of comorbid patients on novel oral anticoagulants (NOACs).
Main Methods:
- Retrospective analysis of 76 COVID-19 patients.
- Comparison of a main group (26 patients on NOACs) with a control group (50 patients not on anticoagulants).
- All patients received standard COVID-19 treatment guidelines.
Main Results:
- Significantly fewer hospitalizations in the NOAC group (19% vs. 66%).
- No deaths or severe respiratory/renal failure in the NOAC group.
- Adverse outcomes occurred in 14% of the control group.
Conclusions:
- NOACs reduce the likelihood of severe COVID-19 and adverse outcomes.
- Coagulation mechanisms play a significant role in COVID-19 pathogenesis.
- Existing NOAC therapy does not require correction for non-severe COVID-19.
Introduction:
Analysis of the pathogenesis of coronavirus infection caused SARS-CoV-2 indicates a significant impact of hemorheological disorders on its course and outcomes. It is known that chronic cardiovascular diseases are associated with the risk of severe course and lethal outcomes both in COVID-19 and other infectious diseases. Therefore, in each case it is necessary to study the interaction and mutual influence of different components of the treatment program prescribed to such patients.The purpose of this work was to evaluate the effect of coagulation activity on the course of a novel coronavirus infection (COVID-19) and to justify the management of comorbid patients having been received novel oral anticoagulants (NOACs) in previously selected doses according to indications in concomitant somatic diseases.
Material And Methods:
Total 76 cases of confirmed coronavirus infection in patients who had been received initial therapy on an outpatient basis were analyzed. 26 patients who received NOACs (rivaroxaban, apixaban, dabigatran) made up the main group and 50 - the comparison (control) group in which patients had not been administered any drugs that affect blood clotting until the episode of COVID-19. All patients have been prescribed therapy following the Provisional guidelines «Prevention, diagnosis and treatment of coronavirus infection (COVID-19)» (https://static-0.minzdrav.gov.ru/system/attachments/attaches/).
Results And Discussion:
The number of hospitalizations was significantly fewer in the group of patients who had been received NOACs (19 vs. 66% in the control group). No deaths or cases of severe respiratory and/or renal failure were observed in the main group, while adverse outcomes were noted in 14% of patients who had not been administered these drugs.
Conclusion:
Taking NOACs reduces the probability of severe course and adverse outcomes in the development of coronavirus infection caused by SARS-CoV-2, which indicates a significant contribution of coagulation mechanisms to the pathogenesis in COVID-19. There were no indications for drug replacement and correction of anticoagulant therapy regimens in patients who received adequate therapy with oral anticoagulants for treating a non-severe form of coronavirus infection in ambulatory patient settings.
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