Abstract Number: PB0175
Meeting: ISTH 2021 Congress
Theme: COVID and Coagulation » COVID and Coagulation, Clinical
Background: Patients with COVID-19 have a hypercoagulable state with increased risk of thrombotic venous events (VTE). These thrombotic complications could be responsible for a significant part of the morbidity and mortality seen in COVID-19 patients. The high incidence of VTE is seen even despite the use of apparently adequate thrombosis prophylaxis. Therefore, it is suggested that in COVID-19 patients increased intensity thromboprophylaxis or therapeutic anticoagulation should be considered.
Aims: We investigated whether the use of therapeutic anticoagulation prior to infection has a beneficial effect on morbidity and mortality in hospitalized COVID-19 patients.
Methods: In this multicenter retrospective cohort study, all ≥18 years old COVID-19 patients admitted to 6 hospitals in the Netherlands between March and May 2020 were included. We applied 1:3 propensity score matching to evaluate the association between prior therapeutic anticoagulation use and clinical outcome, with in hospital mortality as primary endpoint. Relevant secondary outcomes included admission to the intensive care unit (ICU), need for invasive mechanical ventilation, pulmonary embolism and length of hospital stay
Results: A total of 1154 patients were included, of whom 190 (16%) patients used therapeutic anticoagulation prior to admission. In the propensity score matched analyses, we observed no association between prior use of therapeutic anticoagulation and in hospital mortality compared to no prior use of anticoagulation (RR 1.02 (95% CI; 0.80-1.30). We also found no significant differences in secondary outcomes apart from a lower risk of pulmonary embolism in patients using therapeutic anticoagulation prior to infection (RR 0.19 (95% CI; 0.05-0.80).
Conclusions: Although prior therapeutic anticoagulation use is associated with reduced PE occurrence, it is not associated with better outcome parameters in hospitalized COVID-19 patients in terms of all-cause mortality, ICU admittance, need for mechanical ventilation, and length of hospital stay.
To cite this abstract in AMA style:
Spiegelenberg J, van Gelder M, Maas M, Hovens M, Esselink A, Kerckhoffs A, Hoogerwerf J, Janssen N, van Apeldoorn M, Veerman K, Blaauw M, Janssen R, Hassing RJ, Dofferhoff T, van de Maat J, Kramers K, Leentjens J. Prior Use of Therapeutic Anticoagulation Does Not Protect against COVID-19 Related Clinical Outcomes in Hospitalized Patients: A Propensity Score-matched Cohort Study [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/prior-use-of-therapeutic-anticoagulation-does-not-protect-against-covid-19-related-clinical-outcomes-in-hospitalized-patients-a-propensity-score-matched-cohort-study/. Accessed September 24, 2023.« Back to ISTH 2021 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/prior-use-of-therapeutic-anticoagulation-does-not-protect-against-covid-19-related-clinical-outcomes-in-hospitalized-patients-a-propensity-score-matched-cohort-study/