RT Journal Article
T1 Clinical profile and prognosis in patients on oral anticoagulation before admission for COVID-19.
A1 Rivera-Caravaca, Jose Miguel
A1 Nuñez-Gil, Ivan J
A1 Vivas, David
A1 Viana-Llamas, María C
A1 Uribarri, Aitor
A1 Becerra-Muñoz, Víctor Manuel
A1 Trabattoni, Daniela
A1 Fernandez Rozas, Inmaculada
A1 Feltes, Gisela
A1 Lopez-Pais, Javier
A1 El-Battrawy, Ibrahim
A1 Macaya, Carlos
A1 Fernandez-Ortiz, Antonio
A1 Estrada, Vicente
A1 Marin, Francisco
A1 HOPE COVID-19 Investigators, 
K1 Coronavirus disease 2019
K1 SARS-CoV-2
K1 anticoagulant
K1 atrial fibrillation
K1 thrombosis
K1 venous thromboembolism
AB The coronavirus disease 2019 (COVID-19) shows high morbidity and mortality, particularly in patients with concomitant cardiovascular diseases. Some of these patients are under oral anticoagulation (OAC) at admission, but to date, there are no data on the clinical profile, prognosis and risk factors of such patients during hospitalization for COVID-19. Subanalysis of the international 'real-world' HOPE COVID-19 registry. All patients with prior OAC at hospital admission for COVID-19 were suitable for the study. All-cause mortality was the primary endpoint. From 1002 patients included, 110 (60.9% male, median age of 81.5 [IQR 75-87] years, median Short-Form Charlson Comorbidity Index [CCI] of 1 [IQR 1-3]) were on OAC at admission, mainly for atrial fibrillation and venous thromboembolism. After propensity score matching, 67.9% of these patients died during hospitalization, which translated into a significantly higher mortality risk compared to patients without prior OAC (HR 1.53, 95% CI 1.08-2.16). After multivariate Cox regression analysis, respiratory insufficiency during hospitalization (HR 6.02, 95% CI 2.18-16.62), systemic inflammatory response syndrome (SIRS) during hospitalization (HR 2.29, 95% CI 1.34-3.91) and the Short-Form CCI (HR 1.24, 95% CI 1.03-1.49) were the main risk factors for mortality in patients on prior OAC. Compared to patients without prior OAC, COVID-19 patients on OAC therapy at hospital admission showed lower survival and higher mortality risk. In these patients on OAC therapy, the prevalence of several comorbidities is high. Respiratory insufficiency and SIRS during hospitalization, as well as higher comorbidity, pointed out those anticoagulated patients with increased mortality risk.
PB Wiley-Blackwell Publishing Ltd.
YR 2020
FD 2020-10-15
LK http://hdl.handle.net/10668/16456
UL http://hdl.handle.net/10668/16456
LA en
NO Rivera-Caravaca JM, Núñez-Gil IJ, Vivas D, Viana-Llamas MC, Uribarri A, Becerra-Muñoz VM, Trabattoni D, Fernández Rozas I, Feltes G, López-Pais J, et al. Clinical profile and prognosis in patients on oral anticoagulation before admission for COVID-19. Eur J Clin Invest. 2021 Jan;51(1):e13436
NO The authors thank Cardiovascular Excellence SL, for their essential support in the database and registry webpage, and all HOPE COVID-19 researchers.This study was supported by the nonconditioned grant (FundaciónInterhospitalaria para la investigación Cardiovascular, FIC. Madrid, Spain). This nonprofit institution had no role in thestudy design; in the collection, analysis and interpretation of data; in the writing of the report; nor in the decision to submit the paper for publication.
DS RISalud
RD Apr 6, 2025