RT Journal Article
T1 Chronic Oral Anticoagulation Therapy and Prognosis of Patients Admitted to Hospital for COVID-19: Insights from the HOPE COVID-19 Registry.
A1 Rivera-Caravaca, José Miguel
A1 Núñez-Gil, Iván J
A1 Lip, Gregory Y H
A1 Uribarri, Aitor
A1 Viana-Llamas, María C
A1 Gonzalez, Adelina
A1 Castro-Mejía, Alex F
A1 Alonso González, Berta
A1 Alfonso, Emilio
A1 García Prieto, Juan Fortunato
A1 Cavallino, Chiara
A1 Cortese, Bernardo
A1 Feltes, Gisela
A1 Fernández-Rozas, Inmaculada
A1 Signes-Costa, Jaime
A1 Huang, Jia
A1 García Aguado, Marcos
A1 Pepe, Martino
A1 Romero, Rodolfo
A1 Cerrato, Enrico
A1 Becerra-Muñoz, Víctor Manuel
A1 Raposeiras Roubin, Sergio
A1 Santoro, Francesco
A1 Bagur, Rodrigo
A1 Sposato, Luciano
A1 El-Battrawy, Ibrahim
A1 López Masjuan, Alvaro
A1 Fernandez-Ortiz, Antonio
A1 Estrada, Vicente
A1 Macaya, Carlos
A1 Marín, Francisco
AB Most evidence regarding anticoagulation and COVID-19 refers to the hospitalization setting, but the role of oral anticoagulation (OAC) before hospital admission has not been well explored. We compared clinical outcomes and short-term prognosis between patients with and without prior OAC therapy who were hospitalized for COVID-19. Analysis of the whole cohort of the HOPE COVID-19 Registry which included patients discharged (deceased or alive) after hospital admission for COVID-19 in 9 countries. All-cause mortality was the primary endpoint. Study outcomes were compared after adjusting variables using propensity score matching (PSM) analyses. 7698 patients were suitable for the present analysis (675 (8.8%) on OAC at admission: 427 (5.6%) on VKAs and 248 (3.2%) on DOACs). After PSM, 1276 patients were analyzed (638 with OAC; 638 without OAC), without significant differences regarding the risk of thromboembolic events (OR 1.11, 95% CI 0.59-2.08). The risk of clinically relevant bleeding (OR 3.04, 95% CI 1.92-4.83), as well as the risk of mortality (HR 1.22, 95% CI 1.01-1.47; log-rank p value = 0.041), was significantly increased in previous OAC users. Amongst patients on prior OAC only, there were no differences in the risk of clinically relevant bleeding, thromboembolic events, or mortality when comparing previous VKA or DOAC users, after PSM. Hospitalized COVID-19 patients on prior OAC therapy had a higher risk of mortality and worse clinical outcomes compared to patients without prior OAC therapy, even after adjusting for comorbidities using a PSM. There were no differences in clinical outcomes in patients previously taking VKAs or DOACs. This trial is registered with NCT04334291/EUPAS34399.
YR 2022
FD 2022-05-26
LK http://hdl.handle.net/10668/20179
UL http://hdl.handle.net/10668/20179
LA en
DS RISalud
RD Apr 19, 2025