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Prior use of anticoagulation is associated with a better survival in COVID-19

A G Buenen1,2, Marijn Sinkeldam3, Martje L Maas4

  • 1Department of Emergency Medicine, Maxima MC, Postbus 7777, 5500 MB, Veldhoven, The Netherlands. Noud.Buenen@mmc.nl.

Journal of Thrombosis and Thrombolysis
|June 1, 2021
PubMed

Insights

Prior use of anticoagulation (AC) in COVID-19 patients was associated with better survival. Direct oral anticoagulants (DOACs), particularly dabigatran, may offer additional benefits, warranting further investigation into their role in COVID-19 management.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Pharmacology

Background:

  • COVID-19 is linked to a high rate of thromboembolic events.
  • The impact of pre-hospital anticoagulation on COVID-19 outcomes is not well understood.
  • Different oral anticoagulants may influence disease progression differently.

Purpose of the Study:

  • To compare outcomes in COVID-19 patients with prior use of direct oral anticoagulants (DOACs) or vitamin K antagonists (VKAs) versus no anticoagulation.
  • To investigate the influence of different oral anticoagulation types on COVID-19 patient survival.

Main Methods:

  • Observational study of 497 COVID-19 patients presenting to Bernhoven Hospital.
  • Collected baseline characteristics and outcomes, including 30-day all-cause mortality.
  • Utilized multivariable Cox proportional hazards models, adjusting for age, sex, symptom duration, home medication, and comorbidities.

Main Results:

  • Anticoagulation (AC) use was associated with lower body temperature and C-reactive protein levels.
  • Overall prior AC use (DOAC or VKA) showed a reduced risk of 30-day mortality (aHR=0.64, P=0.03).
  • DOAC use demonstrated a significant survival benefit (aHR=0.53, P=0.02), while VKA did not reach statistical significance (aHR=0.77, P=0.30).
  • A subgroup analysis showed all nine patients on dabigatran survived 30 days.

Conclusions:

  • Prior anticoagulation therapy is associated with improved survival in COVID-19 patients.
  • Direct oral anticoagulants, especially dabigatran, may confer additional protective effects.
  • Further research is warranted to elucidate the specific benefits of DOACs in COVID-19 management.

Keywords:
COVID-19Direct oral anticoagulantSARS-CoV-2ThrombosisVitamin K antagonist

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