Prophylactic versus therapeutic anticoagulation for survival of patients with covid-19 on steroid and remdesivir
Circulation
; 144(SUPPL 1), 2021.
Article
in English
| EMBASE | ID: covidwho-1634335
ABSTRACT
Introduction:
Previous observational and randomized studies suggested potential benefit of therapeutic anticoagulation during hospitalization, but this treatment remains controversialObjective:
We aimed to investigate the association of prophylactic and therapeutic anticoagulation with mortality for patients with COVID-19 who were treated with steroids and Remdesivir, which is the current standard treatments.Methods:
This retrospective study was conducted by review of the electronic medical records for 9,565 patients with laboratory confirmed COVID-19 hospitalized in the Mount Sinai Health system between March 1 2020 and March 30 2021. The primary outcome of interest was the in-hospital mortality. Acute kidney injury was defined as any increase of creatinine by more than 0.3mg/dL or to more than 1.5 times baseline. A propensity score analysis (matching and weighting by inverse probability treatment weights) and multiple imputation was performed.Results:
Of the 1,443 patients, 420 (29.1%) had therapeutic anticoagulation therapy. The 1,023 (70.9%) patients with prophylactic anticoagulation were older and had more comorbidities. After matching by propensity score (N=334 in each group), in-hospital mortality was not significantly different between patients with therapeutic anticoagulation and those with prophylactic anticoagulation (26.9% vs. 22.8%, P=0.24). Furthermore, IPTW and multiple imputation for missing data did not change the result (therapeutic versus prophylactic;odds ratio [95% confidential interval] 1.14 [0.83-1.59], P=0.40];1.20 [0.84-1.73], P=0.31, respectively). Interestingly, patients with therapeutic anticoagulation had higher rate of acute kidney injury as compared to patients with prophylactic anticoagulation (26.6% vs. 16.8%, P=0.003).Conclusions:
In conclusion, prophylactic versus therapeutic anticoagulation showed similar inhospital mortality of COVID-19 patients treated with steroids and remdesivir, but therapeutic anticoagulation increased the risk of acute kidney injury compared to prophylactic anticoagulation.
creatinine; remdesivir; steroid; acute, kidney, failure; adult; anticoagulant, therapy; comorbidity; conference, abstract; controlled, study; coronavirus, disease, 2019; drug, combination; drug, therapy; electronic, medical, record; female; hospitalization; human; in-hospital, mortality; major, clinical, study; male; outcome, assessment; overall, survival; probability; propensity, score; retrospective, study
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Type of study:
Prognostic study
Language:
English
Journal:
Circulation
Year:
2021
Document Type:
Article
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