ABSTRACT
AIMS: To estimate if chronic anticoagulant (CAC) treatment is associated with morbidity and mortality outcomes of patients hospitalized for SARS-CoV-2 infection. METHODS: In this European multicentric cohort study, we included 1186 patients of whom 144 were on CAC (12.1%) with positive coronavirus disease 2019 testing between 1 February and 30 July 2020. The average treatment effect (ATE) analysis with a propensity score-matching (PSM) algorithm was used to estimate the impact of CAC on the primary outcomes defined as in-hospital death, major and minor bleeding events, cardiovascular complications (CCI), and acute kidney injury (AKI). We also investigated if different dosages of in-hospital heparin were associated with in-hospital survival. RESULTS: In unadjusted populations, primary outcomes were significantly higher among CAC patients compared with non-CAC patients: all-cause death (35% vs. 18% Pâ<â0.001), major and minor bleeding (14% vs. 8% Pâ=â0.026; 25% vs. 17% Pâ=â0.014), CCI (27% vs. 14% Pâ<â0.001), and AKI (42% vs. 19% Pâ<â0.001). In ATE analysis with PSM, there was no significant association between CAC and primary outcomes except for an increased incidence of AKI (ATE +10.2%, 95% confidence interval 0.3-20.1%, Pâ=â0.044). Conversely, in-hospital heparin, regardless of dose, was associated with a significantly higher survival compared with no anticoagulation. CONCLUSIONS: The use of CAC was not associated with the primary outcomes except for the increase in AKI. However, in the adjusted survival analysis, any dose of in-hospital anticoagulation was associated with significantly higher survival compared with no anticoagulation.
Subject(s)
Acute Kidney Injury , COVID-19 , Acute Kidney Injury/chemically induced , Acute Kidney Injury/epidemiology , Anticoagulants/adverse effects , COVID-19/complications , COVID-19 Testing , Cohort Studies , Hospital Mortality , Hospitals , Humans , Retrospective Studies , Risk Factors , SARS-CoV-2ABSTRACT
Related party transactions ("RPTs") are frequently used as a tool for siphoning off value from a company, but they can also be an efficient instrument for assisting firms. The trade-off between stopping value-decreasing RPTs and promoting value-increasing RPTs requires lawmakers to seek an optimal balance, relying on several contingent factors. This paper highlights the strong interdependency between RPTs regulation and economic changes. After the 2008 crisis, policymakers have enhanced minority shareholders' control over RPTs, considering their involvement as the most effective safeguard against tunnelling. During the COVID-19 crisis, governments have introduced exemptions to the rules on RPTs, even if they might weaken minority shareholders' protection. The reason is that firms face dramatic liquidity shortfalls due to the pandemic, and RPTs can be a vehicle for providing finance to distressed companies, avoiding a wave of bankruptcies that would be dangerous for the economy. Thus, RPTs regulation has been tweaked for adapting to the new economic environment, and these legal changes, in turn, could affect the economic recovery.