The prognostic role of anticoagulants in COVID-19 patients: national COVID-19 cohort in South Korea

被引:0
|
作者
Noh, Hyerim [1 ]
Lee, Jongseong [2 ,3 ]
Chow, Ronald [4 ,5 ,6 ]
Lee, Jihui [7 ]
Simone, Charles B., II [5 ]
Shin, Hyun Joon [4 ,8 ,9 ]
Choi, Young-Geun [1 ,10 ,11 ]
机构
[1] Sookmyung Womens Univ, Dept Stat, 99 Cheongpa Ro 47 Gil, Seoul 04310, South Korea
[2] Columbia Univ, Sch Social Work, New York, NY USA
[3] Minist Hlth & Welf, Sejong, South Korea
[4] Hanyang Impact Sci Res Ctr, Seoul, South Korea
[5] New York Proton Ctr, New York, NY USA
[6] Univ Toronto, Temerty Fac Med, Toronto, ON, Canada
[7] Weill Cornell Med, Dept Populat Llealth Sci, New York, NY USA
[8] Massachusetts Dept Publ Hlth, Lemuel Shattuck Hosp, Dept Med, Div Cardiol, Jamaica Plain, MA USA
[9] Brigham & Womens Hosp, Dept Med, Div Gen Internal Med, 75 Francis St, Boston, MA 02115 USA
[10] Sookmyung Womens Univ, Digital Humanity Ctr, Seoul, South Korea
[11] Sookmyung Womens Univ, Res Inst Nat Sci, Seoul, South Korea
基金
新加坡国家研究基金会;
关键词
Anticoagulant; COVID-19;
D O I
10.21037/apm-21-3466
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Background: There currently exists a paucity of data on whether pre-admission anticoagulants use may have benefits among COVID-19 patients by preventing COVID-19 associated thromboembolism. The aim of this study was to assess the association between pre-admission anticoagulants use and COVID-19 adverse outcomes. Methods: We conducted a population-based cohort studying using the Health Insurance Review and Assessment Service (HIRA) claims data released by the South Korean government. Our study population consisted of South Koreans who were aged 40 years or older and hospitalized with COVID-19 between 1 January 2020 through 15 May 2020. We defined anticoagulants users as individuals with inpatient and outpatient prescription records in 120 days before cohort entry. Our primary endpoint was a composite of all-cause death, intensive care unit (ICU) admission, and mechanical ventilation use. Individual components of the primary endpoint were secondary endpoints. We compared the risk of endpoints between the anticoagulants users and non-users by logistic regression models, with the standardized mortality ratio weighting (SMRW) adjustment. Results: In our cohort of 4,349 patients, for the primary endpoint of mortality, mechanical ventilation and ICU admission, no difference was noted between anticoagulants users and non-users (SMRW OR 1.11, 95% CI: 0.60-2.05). No differences were noted, among individual components. No effect modification was observed by age, sex, history of atrial fibrillation and thromboembolism, and history of cardiovascular disease. When applying the inverse probability of treatment weighting (IPTW) and SMRW with doubly robust methods in sensitivity analysis, anticoagulants use was associated with increased odds of the primary endpoint. Conclusions: Pre-admission anticoagulants were not determined to have a protective role against severe COVID-19 outcomes.
引用
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页码:1317 / +
页数:15
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