The Use of Oral Anticoagulation Is Not Associated With a Reduced Risk of Mortality in Patients With COVID-19: A

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Meng-Fei Dai1,2, Si-Tong Guo3, Yi-Jun Ke4

  • 1Department of Pharmacy, China Pharmaceutical University Nanjing Drum Tower Hospital, Nanjing, China.

Frontiers in Pharmacology
|April 18, 2022
PubMed

Insights

Chronic oral anticoagulation (OAC) did not significantly reduce mortality or ICU admission in COVID-19 patients. This finding was consistent across direct oral anticoagulants (DOACs) and vitamin K antagonists (VKAs).

Area of Science:

  • Medical research focusing on infectious diseases and critical care.
  • Pharmacological interventions for thrombotic complications in viral infections.

Background:

  • Hypercoagulability and thromboembolic events are linked to poor prognosis in COVID-19.
  • The benefit of chronic oral anticoagulation (OAC) in COVID-19 patients remains controversial.

Approach:

  • A systematic review and meta-analysis of 12 studies involving 30,646 patients.
  • Searched PubMed, Embase, Web of Science, and Cochrane Library for relevant studies.
  • Analyzed all-cause mortality and ICU admission rates, comparing OAC users with non-users, and differentiating between DOACs and VKAs.

Key Points:

  • Chronic OAC use was not associated with reduced all-cause mortality (RR: 0.92; 95% CI 0.82-1.03) or ICU admission (RR: 0.65; 95% CI 0.40-1.04) in COVID-19 patients.
  • Subgroup analyses showed no significant difference in mortality reduction between direct oral anticoagulants (DOACs) and vitamin K antagonists (VKAs).
  • Meta-regression did not identify significant confounding factors influencing all-cause mortality.

Conclusions:

  • Chronic oral anticoagulation therapy does not appear to improve clinical outcomes for COVID-19 patients regarding mortality or ICU admission.
  • The findings were consistent regardless of the type of oral anticoagulant used (DOACs or VKAs).

Keywords:
COVID-19direct oral anticoagulantsmeta-analysismortalityoral anticoagulantvitamin K antagonists

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