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Deprecated: Implicit conversion from float 227.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Aging+Clin+Exp+Res 2021 ; 33 (8): 2335-2343 Nephropedia Template TP
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Does chronic oral anticoagulation reduce in-hospital mortality among COVID-19 older patients? #MMPMID34216379
Covino M; De Matteis G; Della Polla D; Burzo ML; Pascale MM; Santoro M; De Cristofaro R; Gasbarrini A; De Candia E; Franceschi F
Aging Clin Exp Res 2021[Aug]; 33 (8): 2335-2343 PMID34216379show ga
BACKGROUND: Patients hospitalized with COVID-19 experienced an increased risk of venous thromboembolism. AIMS: To evaluate the effect of chronic oral anticoagulation (OAC) therapy, both with vitamin K antagonists (VKAs) or direct oral anticoagulants (DOACs), on prognosis of COVID-19 older patients. METHODS: Single-center prospective study conducted in the Emergency Department (ED) of a teaching hospital, referral center for COVID-19 in central Italy. We evaluated all the patients >/= 65 years, consecutively admitted to our ED for confirmed COVID-19. We compared the clinical outcome of those who were on chronic OAC at ED admission with those who did not, using a propensity score matched paired cohort of controls. The primary study endpoint was all-cause in-hospital death. Patients were matched for age, sex, clinical comorbidities, and clinical severity at presentation (based on NEWS >/= 6). Study parameters were assessed for association to all-cause in-hospital death by a multivariate Cox regression analysis to identify independent risk factor for survival. RESULTS: Although overall mortality was slightly higher for anticoagulated patients compared to controls (63.3% vs 43.5%, p = 0.012), the multivariate adjusted hazard ratio (HR) for death was not significant (HR = 1.56 [0.78-3.12]; p = 0.208). Both DOACs (HR 1.46 [0.73-2.92]; p = 0.283) and VKAs (HR 1.14 [0.48-2.73]; p = 0.761) alone did not affect overall survival in our cohort. CONCLUSIONS: Among older patients hospitalized for COVID-19, chronic OAC therapy was not associated with a reduced risk of in-hospital death. Moreover, our data suggest similar outcome both for patients on VKAs or in patients on DOACs.