Your browser doesn't support javascript.
Intermediate-dose anticoagulation, aspirin, and in-hospital mortality in COVID-19: A propensity score-matched analysis.
Meizlish, Matthew L; Goshua, George; Liu, Yiwen; Fine, Rebecca; Amin, Kejal; Chang, Eric; DeFilippo, Nicholas; Keating, Craig; Liu, Yuxin; Mankbadi, Michael; McManus, Dayna; Wang, Stephen Y; Price, Christina; Bona, Robert D; Ochoa Chaar, Cassius Iyad; Chun, Hyung J; Pine, Alexander B; Rinder, Henry M; Siner, Jonathan M; Neuberg, Donna S; Owusu, Kent A; Lee, Alfred Ian.
  • Meizlish ML; Yale School of Medicine, New Haven, Connecticut, USA.
  • Goshua G; Section of Hematology, Department of Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
  • Liu Y; Dana-Farber Cancer Institute, Boston, Massachusetts, USA.
  • Fine R; Department of Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
  • Amin K; Department of Pharmacy, Yale-New Haven Hospital, New Haven, Connecticut, USA.
  • Chang E; Section of Hematology, Department of Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
  • DeFilippo N; Department of Pharmacy, Yale-New Haven Hospital, New Haven, Connecticut, USA.
  • Keating C; School of Pharmacy, University of Connecticut, Storrs, Connecticut, USA.
  • Liu Y; Joint Data Analytics Team, Yale New Haven Hospital, New Haven, Connecticut, USA.
  • Mankbadi M; Section of Hematology, Department of Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
  • McManus D; Department of Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
  • Wang SY; Department of Pharmacy, Yale-New Haven Hospital, New Haven, Connecticut, USA.
  • Price C; Department of Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
  • Bona RD; Section of Allergy and Immunology, Department of Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
  • Ochoa Chaar CI; Section of Hematology, Department of Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
  • Chun HJ; Section of Vascular Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA.
  • Pine AB; Section of Cardiology, Department of Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
  • Rinder HM; Section of Hematology, Department of Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
  • Siner JM; Section of Hematology, Department of Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
  • Neuberg DS; Department of Laboratory Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
  • Owusu KA; Section of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
  • Lee AI; Dana-Farber Cancer Institute, Boston, Massachusetts, USA.
Am J Hematol ; 96(4): 471-479, 2021 04 01.
Article in English | MEDLINE | ID: covidwho-1039153
Preprint
This scientific journal article is probably based on a previously available preprint. It has been identified through a machine matching algorithm, human confirmation is still pending.
See preprint
ABSTRACT
Thrombotic complications occur at high rates in hospitalized patients with COVID-19, yet the impact of intensive antithrombotic therapy on mortality is uncertain. We examined in-hospital mortality with intermediate- compared to prophylactic-dose anticoagulation, and separately with in-hospital aspirin compared to no antiplatelet therapy, in a large, retrospective study of 2785 hospitalized adult COVID-19 patients. In this analysis, we established two separate, nested cohorts of patients (a) who received intermediate- or prophylactic-dose anticoagulation ("anticoagulation cohort", N = 1624), or (b) who were not on home antiplatelet therapy and received either in-hospital aspirin or no antiplatelet therapy ("aspirin cohort", N = 1956). To minimize bias and adjust for confounding factors, we incorporated propensity score matching and multivariable regression utilizing various markers of illness severity and other patient-specific covariates, yielding treatment groups with well-balanced covariates in each cohort. The primary outcome was cumulative incidence of in-hospital death. Among propensity score-matched patients in the anticoagulation cohort (N = 382), in a multivariable regression model, intermediate- compared to prophylactic-dose anticoagulation was associated with a significantly lower cumulative incidence of in-hospital death (hazard ratio 0.518 [0.308-0.872]). Among propensity-score matched patients in the aspirin cohort (N = 638), in a multivariable regression model, in-hospital aspirin compared to no antiplatelet therapy was associated with a significantly lower cumulative incidence of in-hospital death (hazard ratio 0.522 [0.336-0.812]). In this propensity score-matched, observational study of COVID-19, intermediate-dose anticoagulation and aspirin were each associated with a lower cumulative incidence of in-hospital death.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Platelet Aggregation Inhibitors / Aspirin / Hospital Mortality / SARS-CoV-2 / COVID-19 / COVID-19 Drug Treatment / Anticoagulants Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: Am J Hematol Year: 2021 Document Type: Article Affiliation country: Ajh.26102

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Main subject: Platelet Aggregation Inhibitors / Aspirin / Hospital Mortality / SARS-CoV-2 / COVID-19 / COVID-19 Drug Treatment / Anticoagulants Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: Am J Hematol Year: 2021 Document Type: Article Affiliation country: Ajh.26102