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Anticoagulant Use in COVID-19 Patients: A Longitudinal Study From Zanjan, Iran
Vanoushe Azimi Pirsaraei1, Manizhe Jozpanahi2, Koorosh Kamali3
1Research Committee/General Medicine, Zanjan University of Medical Sciences, Zanjan, IRN.
Insights
Prophylactic aspirin with anticoagulants did not lower COVID-19 patient mortality or ICU transfers. Anticoagulant use showed a potential decrease in ICU admissions, warranting further investigation for thrombotic event management.
Area of Science:
- Internal Medicine
- Infectious Diseases
- Cardiology
Background:
- Thrombotic events and associated mortality/morbidity are rising in COVID-19 patients globally.
- The efficacy of prophylactic anticoagulation in Iranian COVID-19 patients requires clarification.
- This study investigates prophylactic anticoagulant use and outcomes in hospitalized COVID-19 patients.
Purpose of the Study:
- To evaluate the impact of prophylactic anticoagulation regimens on outcomes in COVID-19 patients.
- To assess the relationship between anticoagulant use, aspirin, and mortality/ICU admission rates.
- To determine the clinical significance of anticoagulation strategies in managing COVID-19 complications.
Main Methods:
- Longitudinal study of 831 COVID-19 patients hospitalized between March 20 and June 20, 2020.
- Collection of demographic, clinical data, and outcomes from hospital records.
- Statistical analysis using chi-square, Fisher's exact, and Mann-Whitney U tests.
Main Results:
- Mortality rate was 9.4%, with higher rates in older, male patients, and those with comorbidities or ICU admission.
- Concurrent prophylactic anticoagulants and aspirin were linked to significantly higher ICU admission and mortality.
- Anticoagulant prescription was associated with a decrease in ICU admissions.
Conclusions:
- Prophylactic aspirin, with or without anticoagulants, did not reduce mortality or ICU transfers in COVID-19 patients.
- Anticoagulant use showed a potential to decrease ICU admissions, possibly mitigating high ICU mortality.
- Further research is essential to elucidate the benefits of anticoagulants in COVID-19 treatment and thrombotic event prevention.
Abstract:
Background The mortality and morbidity of thrombotic events in patients with coronavirus disease 2019 (COVID-19) are increasing worldwide. The clinical impact of prophylactic anticoagulation regimens among these patients in Iran remains unclear. This study aimed to evaluate the use of prophylactic anticoagulants and outcomes among COVID-19 patients admitted to a tertiary referral hospital. Methodology Patients diagnosed with COVID-19 and hospitalized between March 20 and June 20, 2020, were included in this longitudinal study after obtaining informed consent. Demographic and clinical data were collected from the hospital information system and medical records. Outcomes during this period were also evaluated. The data were entered into the preparation checklist and analyzed using SPSS version 24 software (IBM Corp., Armonk, NY, USA), employing chi-square, Fisher's exact, and Mann-Whitney U tests. Results Of the 831 enrolled patients, 51.9% were female, and 10.6% needed to be admitted to the intensive care unit (ICU). The mean age of the patients was 57.16 ± 17.32 years, and the mortality rate was estimated to be 9.4%. Mortality rates were significantly higher at older ages, in men, patients with ICU admission, severe pulmonary involvement, malignancy, airway obstruction, ischemic heart disease, and previous cerebrovascular accidents. ICU admission and mortality were statistically significantly higher in those who received concurrent prophylactic anticoagulants and aspirin than in other individuals. Conclusions Our study demonstrated that administering prophylactic aspirin with or without anticoagulant agents in COVID-19 patients did not reduce mortality rates or ICU transfers. However, it is worth noting that anticoagulant prescription was associated with a decrease in ICU admissions, which could potentially alleviate the significantly higher mortality rates observed among ICU patients in this study. Further research is needed to explore the potential benefits of anticoagulants in COVID-19 treatment.
