80歳以上の入院COVID-19患者に対する予防性抗凝固薬の効果:多センター前向きコホート研究
Feiya Xu1,2,3, Guohui Fan2,3, Jing Han4
1China-Japan Friendship Hospital (Institute of Clinical Medical Sciences), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100005, China.
European journal of medical research
|August 25, 2025
まとめ
低分子量ヘパリン (LMWH) は,80歳以上の入院COVID-19患者の静脈性血栓栓症および死亡率を効果的に減少させた. 血栓予防は高出血リスクの患者でも安全でした
科学分野:
- 高齢者医療
- 感染症
- 心臓病科
背景:
- 高齢者 (80歳以上) は,SARS-CoV-2感染後のVTEと死亡リスクの増加に直面しています.
- 薬学的な血栓予防は推奨されているが,高齢者ではあまり研究されていない.
- COVID-19は高齢者の間で重大なVTEと死亡リスクをもたらします.
研究 の 目的:
- 低分子量ヘパリン (LMWH) の効果と安全性を評価する.
- 80歳以上の入院COVID-19患者のVTE,死亡率,出血に対するLMWHの影響を評価する.
主な方法:
- 中国での多センター,前向きなコホート研究 (2022年12月〜2023年1月).
- 80歳以上の入院COVID-19患者も含まれています.
- 退院後3ヶ月の追跡調査;多変量コックス回帰を用いた.
主要な成果:
- 1526人の患者の41. 6%がLMWH予防接種を受けた.
- LMWHは,出血が増加することなく,VTEのリスクを50%減らし,死亡率を20%低下させた.
- 血液出血の危険因子:男性,脳卒中歴,重症,低血糖
結論:
- LMWHは,最も高齢のCOVID-19患者の血栓予防に安全で有効であるようです.
- 血行リスクが高い患者でも効果が見られた.
- これらの発見を確認するためにさらなる研究が必要である.
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