The role of anticoagulation therapy in management of covid-19 patients

ABSTRACT

Introduction Hypoxemia, acute respiratory distress syndrome and coagulopathy are common issues experiences by pts with severe COVID-19 disease.1 The aim of this study was to evaluate the efficacy of anticoagulation therapy in COVID-19 patients. Methods This is a retrospective observational study for patients admitted to a busy district hospital during the peak period of the COVID-19 pandemic. All patients aged >18 with suspected or confirmed RT-PCR COVID-19 and raised D-Dimer were included in this study. Data including demographics, comorbidities, and effects of anticoagulation on mortality were examined. Results A total of 628 pts with more males (n = 365;58.1%), and 48.7% >75 years were included in the study. 27.9% were obese (BMI-30);and 25% were overweight (BMI 25-29.9). 448/628 (71.3%) had a positive swab for coronavirus and a further 70 patients (11.1%) had probable infection based on clinic-radiological suspicion. Nearly half (n = 311;49.5%) of the patients had hypertension and a quarter (n = 166;26.4%) had diabetes. A total of 226 (36%) pts died of which 85.8% (n = 194) had a positive swab compared to 12.8% (n = 29) with negative swab. This was statistically significant with a p-value of 0.001. Patients with a raised D-dimer 150/628 (23.8%) received therapeutic dose anticoagulation and 408/628 (64.9%) received prophylaxis or no anticoagulation. 53 patients (22.5%) of those who received treatment dose died compared to 183 (77.5%) who received prophylactic dose or no anticoagulation due to comorbidities. This was statistically significant (p value 0.02). Conclusion Therapeutic anticoagulation significantly reduces mortality in COVID-19 patients with a high D-dimer.