Purpose The clinical course of COVID-19 may be complicated by acute respiratory distress syndrome (ARDS) and thromboembolic events, which are associated with high risk of mortality. Although previous studies reported a lower rate of death in patients treated with heparin, the potential benefit of chronic oral anticoagulation therapy (OAT) remains unknown. We aimed to investigate the association between OAT with the risk of ARDS and mortality in hospitalized patients with COVID-19. Methods This is a multicenter retrospective Italian study including consecutive patients hospitalized for COVID-19 from March 1 to April 22, 2020, at six Italian hospitals. Patients were divided into two groups according to the chronic assumption of oral anticoagulants. Results Overall, 427 patients were included; 87 patients (19%) were in the OAT group. Of them, 54 patients (13%) were on treatment with non-vitamin k oral anticoagulants (NOACs) and 33 (8%) with vitamin-K antagonists (VKAs). OAT patients were older and had a higher rate of hypertension, diabetes, and coronary artery disease compared to No-OAT group. The rate of ARDS at admission (26% vs 28%, P =0.834), or developed during the hospitalization (9% vs 10%, P =0.915), was similar between study groups; in-hospital mortality (22% vs 26%, P =0.395) was also comparable. After balancing for potential confounders by using the propensity score matching technique, no differences were found in term of clinical outcome between OAT and No-OAT patients Conclusion Oral anticoagulation therapy, either NOACs or VKAs, did not influence the risk of ARDS or death in patients hospitalized with COVID-19.
【저자키워드】 COVID-19, SARS-CoV-2, ARDS, outcome, NOACs, VKA, 【초록키워드】 Treatment, therapy, Hospitalized, Mortality, anticoagulation, Hospitalization, risk, diabetes, hypertension, hospitals, Clinical outcome, Coronary artery disease, Clinical course, Patient, death, oral, multicenter, Admission, in-hospital mortality, association, acute respiratory distress, retrospective, propensity score matching, high risk, Oral anticoagulants, Older, Thromboembolic events, no difference, syndrome, previous study, assumption, antagonist, NOAC, Italian, confounder, benefit, OAT, Result, reported, hospitalized patient, comparable, two group, consecutive patient, Italian study, oral anticoagulant, patients hospitalized, patients treated, with COVID-19, 【제목키워드】 clinical, oral, chronic,