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Anticoagulation Before Hospitalization Is a Potential Protective Factor for COVID-19: Insight From a French Multicenter Cohort Study.

ABSTRACT: Background Coronavirus disease 2019 (COVID-19) is a respiratory disease associated with thrombotic outcomes with coagulation and endothelial disorders. Based on that, several anticoagulation guidelines have been proposed. We aimed to determine whether anticoagulation therapy modifies the risk of developing severe COVID-19. Methods and Results Patients with COVID-19 initially admitted in medical wards of 24 French hospitals were included prospectively from February 26 to April 20, 2020. We used a Poisson regression model, Cox proportional hazard model, and matched propensity score to assess the effect of anticoagulation on outcomes (intensive care unit admission or in-hospital mortality). The study enrolled 2878 patients with COVID-19, among whom 382 (13.2%) were treated with oral anticoagulation therapy before hospitalization. After adjustment, anticoagulation therapy before hospitalization was associated with a better prognosis with an adjusted hazard ratio of 0.70 (95% CI, 0.55-0.88). Analyses performed using propensity score matching confirmed that anticoagulation therapy before hospitalization was associated with a better prognosis, with an adjusted hazard ratio of 0.43 (95% CI, 0.29-0.63) for intensive care unit admission and adjusted hazard ratio of 0.76 (95% CI, 0.61-0.98) for composite criteria intensive care unit admission or death. In contrast, therapeutic or prophylactic low- or high-dose anticoagulation started during hospitalization were not associated with any of the outcomes. Conclusions Anticoagulation therapy used before hospitalization in medical wards was associated with a better prognosis in contrast with anticoagulation initiated during hospitalization. Anticoagulation therapy introduced in early disease could better prevent COVID-19-associated coagulopathy and endotheliopathy, and lead to a better prognosis.

SUBMITTER: Chocron R

PROVIDER: S-EPMC8174166 | biostudies-literature | 2021 Apr

REPOSITORIES: biostudies-literature

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Anticoagulation Before Hospitalization Is a Potential Protective Factor for COVID-19: Insight From a French Multicenter Cohort Study.

Chocron Richard R Galand Vincent V Cellier Joffrey J Gendron Nicolas N Pommier Thibaut T Bory Olivier O Khider Lina L Trimaille Antonin A Goudot Guillaume G Weizman Orianne O Alsac Jean Marc JM Geneste Laura L Schmeltz Armand A Panagides Vassili V Philippe Aurélien A Marsou Wassima W Ben Abdallah Iannis I Deney Antoine A El Batti Salma S Attou Sabir S Juvin Philippe P Delmotte Thomas T Messas Emmanuel E Pezel Théo T Planquette Benjamin B Duceau Baptiste B Gaussem Pascale P Sutter Willy W Sanchez Olivier O Waldman Victor V Diehl Jean-Luc JL Mirault Tristan T Bonnet Guillaume G Cohen Ariel A Smadja David M DM

Journal of the American Heart Association 20210208 8

Background Coronavirus disease 2019 (COVID-19) is a respiratory disease associated with thrombotic outcomes with coagulation and endothelial disorders. Based on that, several anticoagulation guidelines have been proposed. We aimed to determine whether anticoagulation therapy modifies the risk of developing severe COVID-19. Methods and Results Patients with COVID-19 initially admitted in medical wards of 24 French hospitals were included prospectively from February 26 to April 20, 2020. We used a ...[more]

PMID: 33550816

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Dataset Information

Anticoagulation Before Hospitalization Is a Potential Protective Factor for COVID-19: Insight From a French Multicenter Cohort Study.

Publications

Anticoagulation Before Hospitalization Is a Potential Protective Factor for COVID-19: Insight From a French Multicenter Cohort Study.

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