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Therapeutic Anticoagulation Is Associated with Decreased Mortality in Mechanically Ventilated COVID-19 Patients
Preprint
em Inglês
| medRxiv
| ID: ppmedrxiv-20117929
ABSTRACT
ObjectiveTo evaluate differences in morbidity and mortality among mechanically ventilated patients with COVID-19 treated with therapeutic versus prophylactic anticoagulation. MethodsWe performed a retrospective review of 245 COVID-19 positive patients admitted to the ICU requiring mechanical ventilation from March 1, 2020 through April 11, 2020 at Mount Sinai Hospital. Patients either received therapeutic anticoagulation for a minimum of 5 days or prophylactic dose anticoagulation. Morbidity and mortality data were analyzed. ResultsPropensity score (PS) weighted Kaplan-Meier plot demonstrated a survival advantage (57% vs. 25%) at 35 days from admission to the ICU in patients who received therapeutic anticoagulation for a minimum of 5 days compared to those who received prophylactic anticoagulation during their hospital course. A multivariate Cox proportional hazard regression model with PS weights to adjust for baseline differences found a 79% reduction in death in patients who were therapeutically anticoagulated HR 0.209, [95% Cl (0.10, 0.46), p < 0.001]. Bleeding complications were similar between both groups. A 26.7% [95% Cl (1.16, 1.39), p< 0.001] excess mortality was found for each 1 mg/dL rise in serum creatinine over a 21-day period. ConclusionsTherapeutic anticoagulation is associated with a survival advantage among patients with COVID-19 who require mechanical ventilation in the ICU.
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Texto completo:
Disponível
Coleções:
Preprints
Base de dados:
medRxiv
Tipo de estudo:
Experimental_studies
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Estudo observacional
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Estudo prognóstico
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Rct
Idioma:
Inglês
Ano de publicação:
2020
Tipo de documento:
Preprint