Beneficial Effects of Anticoagulants on the Clinical Outcomes of COVID-19 Patients

(1) Background: Severe coronavirus disease can be complicated by a hypercoagulable state in conjunction with sepsis, increasing the risk of venous thromboembolism. This study aimed to observe the effect of anticoagulants on 30-day high-dependency unit (HDU) outcomes of moderate to severe coronavirus...

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Autores principales:	Zubia Jamil, Azmat Ali Khan, Samreen Khalid, Muhammad Asghar, Khalid Muhammad, Yasir Waheed
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	COVID-19 SARS-CoV-2 heparin enoxaparin acute respiratory distress syndrome pulmonary embolism Therapeutics. Pharmacology RM1-950
Acceso en línea:	https://doaj.org/article/5aa55937f1ab42d8a8abdafe58387173
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spelling	oai:doaj.org-article:5aa55937f1ab42d8a8abdafe583871732021-11-25T16:24:37ZBeneficial Effects of Anticoagulants on the Clinical Outcomes of COVID-19 Patients10.3390/antibiotics101113942079-6382https://doaj.org/article/5aa55937f1ab42d8a8abdafe583871732021-11-01T00:00:00Zhttps://www.mdpi.com/2079-6382/10/11/1394https://doaj.org/toc/2079-6382(1) Background: Severe coronavirus disease can be complicated by a hypercoagulable state in conjunction with sepsis, increasing the risk of venous thromboembolism. This study aimed to observe the effect of anticoagulants on 30-day high-dependency unit (HDU) outcomes of moderate to severe coronavirus disease 2019 (COVID-19) patients of a tertiary care hospital at Rawalpindi, Pakistan. (2) Methods: A retrospective propensity-based case–control study was carried out to examine COVID-19 patients admitted to the HDU. Patient groups who did and did not receive anticoagulants were labeled as “anticoagulant” and “non-anticoagulant”, respectively. Case–control matching (1:1) was performed via propensity scores (calculated by a regression model). Kaplan–Meier and logrank analyses were used to study survival probability. Single predictors of outcomes were determined by Cox regression analysis. (3) Results: The anticoagulant group had elevated D-dimers, advanced age, more comorbidities and a higher frequency of severe disease compared to the non-anticoagulant group (<i>p</i> < 0.05). Therefore, 47 cases and 47 matched controls were selected based on their propensity scores. The primary endpoint was outcome (survived vs. died). The 30-day in-HDU mortality was 25.5% for cases and 61.7% for controls (<i>p</i> = 0.0004). The median time from admission to death was 16 days for the case group and 7 days for the control group (<i>p</i> < 0.0001). The 30-day mortality was 19.1% for the enoxaparin group and 16.4% for the heparin group (<i>p</i> > 0.05). Enoxaparin (therapeutic and prophylactic doses) and heparin (prophylactic dose) were found to be independent factors affecting the outcomes of these patients (<i>p</i> < 0.001). (4) Conclusions: Anticoagulants play a beneficial role in reducing mortality among COVID-19 patients. Both anticoagulant formulations, enoxaparin (therapeutic and prophylactic doses) and heparin (prophylactic dose), were associated with improving survival among these patients.Zubia JamilAzmat Ali KhanSamreen KhalidMuhammad AsgharKhalid MuhammadYasir WaheedMDPI AGarticleCOVID-19SARS-CoV-2heparinenoxaparinacute respiratory distress syndromepulmonary embolismTherapeutics. PharmacologyRM1-950ENAntibiotics, Vol 10, Iss 1394, p 1394 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	COVID-19 SARS-CoV-2 heparin enoxaparin acute respiratory distress syndrome pulmonary embolism Therapeutics. Pharmacology RM1-950
spellingShingle	COVID-19 SARS-CoV-2 heparin enoxaparin acute respiratory distress syndrome pulmonary embolism Therapeutics. Pharmacology RM1-950 Zubia Jamil Azmat Ali Khan Samreen Khalid Muhammad Asghar Khalid Muhammad Yasir Waheed Beneficial Effects of Anticoagulants on the Clinical Outcomes of COVID-19 Patients
description	(1) Background: Severe coronavirus disease can be complicated by a hypercoagulable state in conjunction with sepsis, increasing the risk of venous thromboembolism. This study aimed to observe the effect of anticoagulants on 30-day high-dependency unit (HDU) outcomes of moderate to severe coronavirus disease 2019 (COVID-19) patients of a tertiary care hospital at Rawalpindi, Pakistan. (2) Methods: A retrospective propensity-based case–control study was carried out to examine COVID-19 patients admitted to the HDU. Patient groups who did and did not receive anticoagulants were labeled as “anticoagulant” and “non-anticoagulant”, respectively. Case–control matching (1:1) was performed via propensity scores (calculated by a regression model). Kaplan–Meier and logrank analyses were used to study survival probability. Single predictors of outcomes were determined by Cox regression analysis. (3) Results: The anticoagulant group had elevated D-dimers, advanced age, more comorbidities and a higher frequency of severe disease compared to the non-anticoagulant group (<i>p</i> < 0.05). Therefore, 47 cases and 47 matched controls were selected based on their propensity scores. The primary endpoint was outcome (survived vs. died). The 30-day in-HDU mortality was 25.5% for cases and 61.7% for controls (<i>p</i> = 0.0004). The median time from admission to death was 16 days for the case group and 7 days for the control group (<i>p</i> < 0.0001). The 30-day mortality was 19.1% for the enoxaparin group and 16.4% for the heparin group (<i>p</i> > 0.05). Enoxaparin (therapeutic and prophylactic doses) and heparin (prophylactic dose) were found to be independent factors affecting the outcomes of these patients (<i>p</i> < 0.001). (4) Conclusions: Anticoagulants play a beneficial role in reducing mortality among COVID-19 patients. Both anticoagulant formulations, enoxaparin (therapeutic and prophylactic doses) and heparin (prophylactic dose), were associated with improving survival among these patients.
format	article
author	Zubia Jamil Azmat Ali Khan Samreen Khalid Muhammad Asghar Khalid Muhammad Yasir Waheed
author_facet	Zubia Jamil Azmat Ali Khan Samreen Khalid Muhammad Asghar Khalid Muhammad Yasir Waheed
author_sort	Zubia Jamil
title	Beneficial Effects of Anticoagulants on the Clinical Outcomes of COVID-19 Patients
title_short	Beneficial Effects of Anticoagulants on the Clinical Outcomes of COVID-19 Patients
title_full	Beneficial Effects of Anticoagulants on the Clinical Outcomes of COVID-19 Patients
title_fullStr	Beneficial Effects of Anticoagulants on the Clinical Outcomes of COVID-19 Patients
title_full_unstemmed	Beneficial Effects of Anticoagulants on the Clinical Outcomes of COVID-19 Patients
title_sort	beneficial effects of anticoagulants on the clinical outcomes of covid-19 patients
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/5aa55937f1ab42d8a8abdafe58387173
work_keys_str_mv	AT zubiajamil beneficialeffectsofanticoagulantsontheclinicaloutcomesofcovid19patients AT azmatalikhan beneficialeffectsofanticoagulantsontheclinicaloutcomesofcovid19patients AT samreenkhalid beneficialeffectsofanticoagulantsontheclinicaloutcomesofcovid19patients AT muhammadasghar beneficialeffectsofanticoagulantsontheclinicaloutcomesofcovid19patients AT khalidmuhammad beneficialeffectsofanticoagulantsontheclinicaloutcomesofcovid19patients AT yasirwaheed beneficialeffectsofanticoagulantsontheclinicaloutcomesofcovid19patients
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Beneficial Effects of Anticoagulants on the Clinical Outcomes of COVID-19 Patients

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