Treatment with prophylactic oral anticoagulants and the risk of mortality in COVID-19 patients: a nationwide cohort study
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Treatment with prophylactic oral anticoagulants and the risk of mortality in COVID-19 patients : a nationwide cohort study. / Altaraihi, Sarah; Kamstrup, Peter; Eklöf, Josefin; Johansen, Niklas Dyrby; Biering-Sørensen, Tor; Sivapalan, Pradeesh; Jensen, Jens Ulrik.
I: ERJ Open Research, Bind 9, Nr. 3, 00644-2022, 2023.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Treatment with prophylactic oral anticoagulants and the risk of mortality in COVID-19 patients
T2 - a nationwide cohort study
AU - Altaraihi, Sarah
AU - Kamstrup, Peter
AU - Eklöf, Josefin
AU - Johansen, Niklas Dyrby
AU - Biering-Sørensen, Tor
AU - Sivapalan, Pradeesh
AU - Jensen, Jens Ulrik
N1 - Publisher Copyright: © 2023, European Respiratory Society. All rights reserved.
PY - 2023
Y1 - 2023
N2 - Background Venous thromboembolism has been reported in patients with coronavirus disease 2019 (COVID- 19). It remains unclear if premorbid use of prophylactic oral anticoagulation, for reasons other than COVID-19, protects against death in patients with COVID-19. The aim of this study was to estimate if the risk of all-cause mortality, hospital admission or intensive care unit (ICU) admission for individuals with verified SARS-CoV-2 was lower if patients used oral anticoagulant (OAC) therapy prior to a positive COVID-19 status. Methods Data were obtained using national health registries. Cohort entry was the day of a positive SARS-CoV-2 test, and individuals were followed for 14 days or until death or hospital admission. Adjusted Cox proportional hazard regressions and competing risk analyses were used to estimate the risk of all-cause mortality, hospital admission and ICU admission in OAC users compared with patients with no use of OAC. Results In this nationwide cohort study a total of 244 522 individuals were included (median age 35 years (interquartile range 21–52); 124 095 (51%) female), among whom 3710 (1.5%) were OAC users. In the adjusted Cox regression cohort, there was no difference in risk of all-cause mortality in OAC versus non- OAC users. (hazard ratio (HR) 1.13, 95% CI 0.99–1.30). Hospital admission risk (HR 1.11, 95% CI 1.02– 1.20) was slightly increased in OAC users, and there was no difference between the groups regarding the risk of ICU admission (HR 0.96, 95% CI 0.74–1.24). Conclusions In individuals with confirmed SARS-CoV-2, pre-existing treatment with OAC was not associated with prophylactic benefits in the prevention of hospital admission, ICU admissions or death. Prescription patterns should remain unchanged.
AB - Background Venous thromboembolism has been reported in patients with coronavirus disease 2019 (COVID- 19). It remains unclear if premorbid use of prophylactic oral anticoagulation, for reasons other than COVID-19, protects against death in patients with COVID-19. The aim of this study was to estimate if the risk of all-cause mortality, hospital admission or intensive care unit (ICU) admission for individuals with verified SARS-CoV-2 was lower if patients used oral anticoagulant (OAC) therapy prior to a positive COVID-19 status. Methods Data were obtained using national health registries. Cohort entry was the day of a positive SARS-CoV-2 test, and individuals were followed for 14 days or until death or hospital admission. Adjusted Cox proportional hazard regressions and competing risk analyses were used to estimate the risk of all-cause mortality, hospital admission and ICU admission in OAC users compared with patients with no use of OAC. Results In this nationwide cohort study a total of 244 522 individuals were included (median age 35 years (interquartile range 21–52); 124 095 (51%) female), among whom 3710 (1.5%) were OAC users. In the adjusted Cox regression cohort, there was no difference in risk of all-cause mortality in OAC versus non- OAC users. (hazard ratio (HR) 1.13, 95% CI 0.99–1.30). Hospital admission risk (HR 1.11, 95% CI 1.02– 1.20) was slightly increased in OAC users, and there was no difference between the groups regarding the risk of ICU admission (HR 0.96, 95% CI 0.74–1.24). Conclusions In individuals with confirmed SARS-CoV-2, pre-existing treatment with OAC was not associated with prophylactic benefits in the prevention of hospital admission, ICU admissions or death. Prescription patterns should remain unchanged.
U2 - 10.1183/23120541.00644-2022
DO - 10.1183/23120541.00644-2022
M3 - Journal article
C2 - 37228282
AN - SCOPUS:85160610753
VL - 9
JO - ERJ Open Research
JF - ERJ Open Research
SN - 2312-0541
IS - 3
M1 - 00644-2022
ER -
ID: 370570817