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Chronic anticoagulant treatment and risk of mortality in SARS-Cov2 patients: a large population-based study

Matteo Montorfano1, Olivia Leoni2, Aida Andreassi2

  • 1Unit of Interventional Cardiology, IRCCS San Raffaele Scientific Institute, Milan, Italy - montorfano.matteo@hsr.it.

Minerva Medica
|February 22, 2022
PubMed

Insights

Pre-existing anticoagulant or antiplatelet therapy did not reduce mortality in COVID-19 patients. This large study found no survival benefit from antithrombotic treatment before infection for SARS-CoV-2 outcomes.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Public Health

Background:

  • COVID-19 is associated with hypercoagulability and frequent thromboembolic events.
  • Antithrombotic treatment is considered for COVID-19 management.
  • The protective effect of pre-infection antithrombotic therapy on COVID-19 outcomes requires investigation.

Purpose of the Study:

  • To evaluate the impact of pre-existing anticoagulant or antiplatelet treatment on COVID-19 mortality.
  • To assess the association between chronic antithrombotic therapy and outcomes in COVID-19 patients.

Main Methods:

  • A large population-based study included over 79,000 COVID-19 patients aged ≥40 years in Lombardy, Italy.
  • The study analyzed the impact of pre-existing chronic anticoagulant (VKA, NOAC) and antiplatelet therapy on COVID-19 mortality.
  • Statistical analyses were performed to evaluate the association between antithrombotic use and mortality risk.

Main Results:

  • Among 79,934 COVID-19 patients, 6.0% were on chronic anticoagulants and 12.7% on antiplatelets prior to infection.
  • Overall unadjusted mortality was 20.6%, with male sex, age, and comorbidities significantly associated with increased risk.
  • Chronic anticoagulant or antiplatelet treatment before infection was not associated with a reduction in COVID-19 mortality.

Conclusions:

  • Pre-existing antithrombotic therapy in over 79,000 COVID-19 patients showed no association with reduced mortality.
  • Further research is necessary to determine the role of antithrombotic therapy as a standard treatment for COVID-19 patients.
  • The findings do not support the use of pre-infection antithrombotic therapy for improving COVID-19 survival outcomes.
Abstract

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