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Rivera-Caravaca, JM, Buckley, BJR, Harrison, SL, Fazio-Eynullayeva, E, Underhill, P, Marin, F and Lip, GYH (2021) Direct-acting oral anticoagulants use prior to COVID-19 diagnosis and associations with 30-day clinical outcomes. Thrombosis Research, 205. pp. 1-7. ISSN 0049-3848
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Direct-acting oral anticoagulants use prior to COVID-19 diagnosis and associations with 30-day clinical outcomes.pdf - Accepted Version Available under License Creative Commons Attribution Non-commercial No Derivatives. Download (556kB) | Preview |
Abstract
Background: It is unclear if direct-acting oral anticoagulants (DOACs) use before hospitalization due to COVID-19 diagnosis would potentially impact the severity and clinical outcomes thereafter. We compared 30-day hospitalization/re-hospitalization and clinical outcomes between patients on chronic DOAC therapy and patients not on oral anticoagulation (OAC) therapy at time of COVID-19 diagnosis. Methods: We used data from TriNetX, a global federated health research network. Patients aged ≥18 years who were treated with DOACs at time of COVID-19 diagnosis between 20 January 2020 and 28 February 2021 were included, and matched with patients not on OAC therapy from the same period. All patients were followed-up at 30-days after COVID-19 diagnosis. The primary outcomes were all-cause mortality, hospitalization/re-hospitalization, venous thromboembolism (VTE) and intracranial hemorrhage (ICH). Results: 738,423 patients were included. After propensity score matching (PSM), 26,006 patients remained in the study (13,003 on DOACs; 13,003 not on OAC). DOAC-treated patients (mean age 67.1 ± 15.4 years, 52.2% male) had higher relative risks (RRs) and lower 30-days event-free survival as compared to patients not on OAC for all-cause mortality (RR 1.27, 95% CI 1.12–1.44; Log-Rank test p = 0.010), hospitalization/re-hospitalization (RR 1.72, 95% CI 1.64–1.82; Log-Rank test p < 0.001) and VTE (RR 4.51, 95% CI 3.91–5.82; Log-Rank test p < 0.001), but not for ICH (RR 0.90, 95% CI 0.54–1.51; Log-Rank test p = 0.513). Conclusion: In COVID-19 patients, previous DOAC therapy at time of diagnosis was not associated with improved clinical outcomes or lower hospitalization/re-hospitalization rate compared to patients not taking OAC therapy.
| Item Type: | Article |
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| Uncontrolled Keywords: | Science & Technology; Life Sciences & Biomedicine; Hematology; Peripheral Vascular Disease; Cardiovascular System & Cardiology; Coronavirus disease 2019; SARS-CoV-2; Thrombosis; Anticoagulant; Direct-acting oral anticoagulants; Bleeding; Mortality; Humans; Anticoagulants; Administration, Oral; Adolescent; Adult; Aged; Aged, 80 and over; Middle Aged; Female; Male; Venous Thromboembolism; Factor Xa Inhibitors; COVID-19; SARS-CoV-2; COVID-19 Testing; Anticoagulant; Bleeding; Coronavirus disease 2019; Direct-acting oral anticoagulants; Mortality; SARS-CoV-2; Thrombosis; Administration, Oral; Adolescent; Adult; Aged; Aged, 80 and over; Anticoagulants; COVID-19; COVID-19 Testing; Factor Xa Inhibitors; Female; Humans; Male; Middle Aged; SARS-CoV-2; Venous Thromboembolism; 1103 Clinical Sciences; Cardiovascular System & Hematology |
| Subjects: | R Medicine > R Medicine (General) |
| Divisions: | Nursing & Allied Health Sport & Exercise Sciences |
| Publisher: | Elsevier |
| SWORD Depositor: | A Symplectic |
| Date Deposited: | 01 Jul 2022 08:36 |
| Last Modified: | 01 Jul 2022 08:45 |
| DOI or ID number: | 10.1016/j.thromres.2021.06.014 |
| URI: | https://researchonline.ljmu.ac.uk/id/eprint/16825 |
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