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Published on: February 28, 2012
Anticoagulation treatment for patients with coronavirus disease 2019 (COVID-19) and its clinical effectiveness in
Jingyi Ge1, Yingmin Ma2, Zhipeng Wu2
1Department of Respiratory Medicine, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, People's Republic of China.
Insights
Anticoagulation in coronavirus disease 2019 patients, including prophylactic and therapeutic doses, reduced mortality compared to no anticoagulation. This finding aids in developing effective treatment strategies for the ongoing outbreak.
Area of Science:
- Medical research
- Clinical pharmacology
- Epidemiology
Background:
- Coronavirus disease 2019 (COVID-19) poses significant public health challenges.
- Effective anticoagulant treatment strategies are crucial for managing COVID-19 patients.
- Understanding the risks and benefits of anticoagulation is vital for treatment protocols.
Purpose of the Study:
- To evaluate the effectiveness of prophylactic and therapeutic anticoagulation in COVID-19 patients.
- To compare mortality rates, bleeding risk, deep vein thrombosis, and pulmonary embolism.
- To inform treatment guidelines for COVID-19 management.
Main Methods:
- A systematic literature search was conducted across multiple databases (Cochrane Library, Pubmed, EMBASE, etc.) from November 2019 to October 2020.
- Fourteen studies involving 7681 patients were included after methodological quality review.
- A random-effects model was employed for meta-analysis, with heterogeneity and publication bias assessed.
Main Results:
- Both prophylactic and therapeutic anticoagulation showed no significant difference in bleeding, deep vein thrombosis, or pulmonary embolism risk compared to no anticoagulation.
- Anticoagulation (prophylactic and therapeutic) was associated with a lower risk of mortality compared to no anticoagulation.
- Therapeutic anticoagulation increased bleeding risk compared to prophylactic anticoagulation but reduced deep vein thrombosis risk.
Conclusions:
- Anticoagulation, both prophylactic and therapeutic, is beneficial for reducing mortality in COVID-19 patients.
- Findings support the use of anticoagulation in COVID-19 management.
- Results provide evidence for healthcare providers and policymakers in controlling the COVID-19 outbreak.
Background:
To better inform efforts to treat and control the current outbreak with effective anticoagulant treatment strategies for coronavirus disease 2019 patients.
Methods:
We searched Cochrane Library, Pubmed, EMBASE, MEDLINE, SCIEXPANDED, Web of Science, Google Scholar, CNKI (Chinese Database), WanFang (Chinese Database), CBM (Chinese Database), VIP (Chinese Database) for studies published from November 1, 2019 to October 1, 2020, and we searched references of identified articles. Studies were reviewed for methodological quality. A random-effects model was used to pool results. Heterogeneity was assessed using I2. Publication bias was assessed using funnel plot.
Results:
Fourteen studies involving 7681 patients were included. We meta-analyzed the bleeding, deep vein thrombosis, and pulmonary embolism risk between no anticoagulation and prophylactic anticoagulation, and found no significant difference. The same trend occurred in the comparison between with and without anticoagulation. However, when compared with no anticoagulation, both prophylactic anticoagulation (odd ratio [OR] = 0.80, 95% confidence interval [CI]: 0.69-0.93) and therapeutic anticoagulation (OR = 0.91, 95% CI: 0.80-1.05) had lower risk of mortality. Furthermore, the risk of overall bleeding among patients with therapeutic anticoagulation was 3.11 times (95% CI: 2.29-4.24) than that of patients with prophylactic anticoagulation. On the contrary, therapeutic anticoagulation had lower risk of deep vein thrombosis than prophylactic anticoagulation (OR = 0.34, 95% CI: 0.19-0.63).
Conclusions:
Among coronavirus disease 2019 patients, preventive and therapeutic anticoagulation were more beneficial than no anticoagulation for reducing mortality rate. The result will inform healthcare providers and public health policy makers in efforts to treat and control the current outbreak.
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