Background: Anticoagulation is generally used in hospitalized patients with coronavirus disease 2019 (COVID-19) as thromboprophylaxis. However, results from different studies comparing the effect of anticoagulation on the mortality of COVID-19 patients with non-anticoagulation are inconclusive. Methods: Our systematic review included observational trials if they studied anticoagulant therapy in hospitalized patients with COVID-19 for mortality or bleeding events. Dichotomous variables from individual studies were pooled by risk ratio (RR) and their 95% confidence interval (95% CI) using the random-effects model. Grading of Recommendations Assessment, Development and Evaluation was used to assess the quality of evidence. Results: A total of 11 observational studies enrolling 20,748 hospitalized COVID-19 patients overall were included. A pooled meta-analysis of these studies showed that anticoagulation therapy, compared with non-anticoagulation therapy, was associated with lower mortality risk (RR 0.70, 95% CI 0.52–0.93, p = 0.01). The evidence of benefit was stronger among critically ill COVID-19 patients in the intensive care units (RR 0.59, 95% CI 0.43–0.83, p = 0.002). Additionally, severe bleeding events were not associated with the administration of anticoagulants (RR 0.93, 95% CI 0.71–1.23, p = 0.63). Conclusion: Among patients with COVID-19 admitted to hospital, the administration of anticoagulants was associated with a decreased mortality without increasing the incidence of bleeding events.
【저자키워드】 Coronavirus disease 2019, Mortality, anticoagulation, heparin, bleeding, 【초록키워드】 COVID-19, coronavirus disease, Meta-analysis, therapy, Trial, hospital, intensive care unit, systematic review, risk, observational study, Critically ill, incidence, assessment, development, hospitalized COVID-19 patient, Thromboprophylaxis, Anticoagulant, Evidence, administration, COVID-19 patient, anticoagulant therapy, 95% CI, 95% confidence interval, decreased mortality, random-effects model, bleeding events, variable, Inconclusive, benefit, lower mortality risk, was used, hospitalized patient, bleeding event, patients with COVID-19, with COVID-19, 【제목키워드】 review, Effect,