Real-World Management of Pharmacological Thromboprophylactic Strategies for COVID-19 Patients in Japan: From the CLOT-COVID Study.
JACC Asia
; 2(7): 897-907, 2022 Dec.
Article
in English
| MEDLINE | ID: covidwho-2179892
ABSTRACT
Background:
Data on prophylactic anticoagulation are important in understanding the current issues, unmet needs, and optimal management of Japanese COVID-19 patients.Objectives:
This study aimed to investigate the clinical management strategies for prophylactic anticoagulation of COVID-19 patients in Japan.Methods:
The CLOT-COVID study was a multicenter observational study that enrolled 2,894 consecutive hospitalized patients with COVID-19. The study population consisted of 2,889 patients (after excluding 5 patients with missing data); it was divided into 2 groups patients with pharmacological thromboprophylaxis (n = 1,240) and those without (n = 1,649). Furthermore, we evaluated the 1,233 patients who received prophylactic anticoagulation-excluding 7 patients who could not be classified based on the intensity of their anticoagulants-who were then divided into 2 groups patients receiving prophylactic anticoagulant doses (n = 889) and therapeutic anticoagulant doses (n = 344).Results:
The most common pharmacological thromboprophylaxis anticoagulant was unfractionated heparin (68.2%). The severity of COVID-19 at admission was a predictor of the implementation of pharmacological thromboprophylaxis in the multivariable analysis (moderate vs mild OR 16.6; 95% CI13.2-21.0; P < 0.001, severe vs mild OR 342.6, 95% CI 107.7-1090.2; P < 0.001). It was also a predictor of the usage of anticoagulants of therapeutic doses in the multivariable analysis (moderate vs mild OR 2.10; 95% CI 1.46-3.02; P < 0.001, severe vs mild OR 5.96; 95% CI 3.91-9.09; P < 0.001).Conclusions:
In the current real-world Japanese registry, pharmacological thromboprophylaxis, especially anticoagulants at therapeutic doses, was selectively implemented in COVID-19 patients with comorbidities and severe COVID-19 status at admission.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Type of study:
Experimental Studies
/
Observational study
/
Prognostic study
/
Randomized controlled trials
Language:
English
Journal:
JACC Asia
Year:
2022
Document Type:
Article
Affiliation country:
J.jacasi.2022.09.005
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