CRT-200.07 Cardiovascular Outcomes of Long-Term Anticoagulation in COVID-19 Hospitalizations: A Nationwide Analysis

ABSTRACT

Introduction: It is now evident that anticoagulation plays a key role in the management of COVID-19 infection, however the significance of previous long-term oral anticoagulation in patients who later presented with COVID-19 is still unknown. Here we present an analysis of the impact of long-term oral AC on COVID-19 hospitalizations at the national cohort registry. Method(s) The NIS database from 2020 was queried to identify COVID-19 patients on long term AC use. Multivariate regression was done to compare inpatient outcomes among COVID-19 patients with and without AC. Result(s) Of 1,060,925 patients with primary diagnosis of COVID, 102, 560 (9.6%) were on AC. On adjusted analysis, patients with COVID-19 and AC use had significantly lower odds of MACCE (aOR 0.63, 95% CI 0.6-0.66, p<0.001), in-hospital mortality (aOR 0.61, 95% CI 0.58-0.64, p<0.001), cardiac arrest (aOR 0.67, 95% CI 0.6-0.75, P<0.001), acute MI (aOR 0.72, 95% CI 0.63-0.83, P<0.001), stroke (aOR 0.79, 95% CI 0.66-0.95, P=0.002), cardiogenic shock (aOR 0.58, 95% CI 0.44-0.75, P<0.001), ICU admission, (aOR 0.53, 95% CI 0.49-.57, p<0.001) mechanical ventilation,(aOR 0.54, 95% CI 0.51-.58, p<0.001) tracheostomy, (aOR 0.4, 95% CI 0.32-.5, p<0.001) and septic shock, (aOR 0.53, 95% CI 0.48-.58, p<0.001) compared to patients without AC. Additionally, lower adjusted total charge ($70,987+/-109,234 vs 79,239+/-153,418, p<0.001) in patients taking AC was observed. However, the adjusted OR of major bleeding, MCS, PCI, new HD and length of stay were similar between the two groups. Conclusion(s) Patients with COVID-19 infection who are on long term AC use have lower risk of MACCE, in-hospital mortality, cardiac arrest, acute MI, stroke cardiogenic shock and ICU admissions with no significant increased risk of major bleeding. Large prospective trials are needed to validate these findings. [Formula presented]Copyright © 2023