Related Experiment Video
Updated: Aug 16, 2025
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
Effect of Previous Anticoagulant Treatment on Risk of COVID-19
Maruxa Zapata-Cachafeiro1,2,3, Ángela Prieto-Campo1, Manuel Portela-Romero4,5
1Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.
Insights
Anticoagulant use, specifically antivitamin K and direct-acting types, did not worsen COVID-19 severity. Antivitamin K was linked to reduced hospitalization and infection risk, while direct-acting anticoagulants also showed decreased susceptibility.
Area of Science:
- Pharmacology
- Infectious Diseases
- Epidemiology
Background:
- The role of anticoagulants in COVID-19 pathogenesis and outcomes remains incompletely understood.
- Previous anticoagulant treatment's impact on COVID-19 risk requires further investigation.
Purpose of the Study:
- To evaluate the association between prior anticoagulant use and COVID-19 hospitalization risk.
- To assess the effect of anticoagulants on COVID-19 progression to severe disease.
- To determine anticoagulant influence on susceptibility to SARS-CoV-2 infection.
Main Methods:
- A population-based case-control study was conducted in northwest Spain during 2020.
- Three models assessed hospitalization, disease progression, and infection susceptibility using PCR-confirmed COVID-19 cases and matched controls.
- Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were computed via generalized linear mixed models.
Main Results:
- Antivitamin K (AVK) anticoagulants were associated with a significantly lower risk of hospitalization (OR 0.77 [95% CI 0.64-0.93]) and reduced susceptibility to infection (OR 0.83 [95% CI 0.74-0.92]).
- Direct-acting anticoagulants (DOACs) showed no association with hospitalization risk but suggested decreased susceptibility (OR 0.85 [95% CI 0.74-0.98]).
- Neither AVK nor DOACs were linked to an increased risk of progression to severe COVID-19. Low-molecular-weight heparins (LMWH) showed an increased risk of progression (OR 1.25 [95% CI 1.01-1.55]).
Conclusions:
- Anticoagulant therapies, including AVK and DOACs, do not elevate the risk of severe COVID-19 progression.
- AVK use is associated with a reduced risk of COVID-19 hospitalization and infection susceptibility.
- DOACs may also decrease susceptibility to COVID-19 infection, warranting further research into their protective effects.
Introduction:
Little is known about the role played by anticoagulants in COVID-19.
Objective:
The aim of this study was to assess the impact of previous anticoagulant treatment on risk of hospitalization due to COVID-19, progression to severe COVID-19 and susceptibility to COVID-19 infection.
Methods:
We conducted a multiple population-based case-control study in northwest Spain, in 2020, to assess (1) risk of hospitalization: cases were all patients admitted due to COVID-19 with PCR confirmation, and controls were a random matched sample of subjects without a positive PCR; (2) progression: cases were hospitalized COVID-19 subjects, and controls were all non-hospitalized COVID-19 patients; and (3) susceptibility: cases were patients with a positive PCR (hospitalized and non-hospitalized), and the controls were the same as for the hospitalization model. Adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated using a generalized linear mixed model.
Results:
The consumption of antivitamin K and direct-acting anticoagulants apparently was not associated with the risk of progression to severe COVID-19 (OR 0.93 [95% CI 0.74-1.17] and OR 1.04 [95% CI 0.79-1.36], respectively). Antivitamin K anticoagulants were associated with a significantly lower risk of hospitalization (OR 0.77 [95% CI 0.64-0.93]), which, in part, can be explained by a decreased risk of susceptibility to infection (OR 0.83 [95% CI 0.74-0.92]). The use of direct-acting anticoagulants was not associated with the risk of hospitalization, although it also seems to decrease susceptibility (OR 0.85 [95% CI 0.74-0.98]). It has also been observed that low-molecular-weight heparins were associated with an increased risk of progression to severe COVID-19 (OR 1.25 [95% CI 1.01-1.55]).
Conclusion:
The results of this study have shown that antivitamin K anticoagulants and direct-acting anticoagulants do not increase the risk of progression to more severe stages. Antivitamin K consumption was associated with a lower risk of hospitalization and susceptibility to infection.
Related Concept Videos
01:18Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
01:29Venous Thrombosis III: Interprofessional Care
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
01:14Myocarditis III: Medical Management
01:26Coronary Artery Disease IV: Preventive Measures