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Anticoagulant treatment and COVID-19

Year 2022, Volume: 9 Issue: 1, 106 - 111, 31.03.2022
https://doi.org/10.34087/cbusbed.1007918

Abstract

Objective: In this study, we aimed to examine the effect of atrial fibrillation (AF) on mortality in COVID-19 patients and the risk scores that can be used in determining risky AF patients. In addition, we aimed to examine the place of oral anticoagulant use in treatment.
Materials and Methods: Records of patients diagnosed with COVID-19 were retrospectively reviewed. Among these patients, 48 patients with a diagnosis of AF were identified. Intensive care need, mortality, CHA2DS2VASC and HAS-BLED scores of the patients were recorded. CRP and D-Dimer levels were recorded. Oral anticoagulant treatments used by the patients were recorded.
Results: The CHA2DS2VASC (intensive care: 4,50±1,41, internal medicine service: 2,50±1,05, p<0,05) and HAS-BLED (intensive care: 2,0±1,08, internal medicine service: 1,5±0,77, p<0,05) scores of the patients followed in the intensive care unit were higher. Non-Survivor Patients with atrial fibrillation had higher CRP (survivor: 21,50±15,23, non-survivor: 142,30±48,49, p<0,05) and D-Dimer (survivor: 183,47±43,68, non-survivor: 878,98±112,24, p<0,05) values. While 24 of the patients continued their oral anticoagulant use, 24 of them used low molecular weight heparin (LMWH). No bleeding was detected in any of these patients. Anemia requiring erythrocyte replacement was similarbetween the two groups (oral anticoagulant: 2 (8,3%), LMWH: 3 (12,5%), p:0,152). Mortality was similar between both groups (oral anticoagulant: 5 (20,8%), LMWH: 5 (20,8%), p: 0,248).
Conclusion: AF is an important cardiovascular risk factor affecting mortality in COVID-19. CHA2DS2VASC and HAS-BLED scores are important in determining patients at risk. CRP and D-Dimer are important laboratory parameters in determining risky AF patients. Anticoagulant treatments used by patients can be considered instead of LMWH recommended in the treatment of COVID-19.

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Dear Editor, Please find attached our manuscript for publication in Celal Bayar Sağlık Bilimleri Enstitüsü Dergisi entitled: Anticoagulant treatment and COVID-19 Article category preference: Original Article The work described here has not been published before; it is not under consideration for publication anywhere else and its publication has been approved by all co-authors. In case of any questions please do not hesitate to contact us anytime. Funding: None Conflict of interest for all authors: None All authors had access to the data and a role in writing the manuscript Address for correspondence İbrahim Halil Özdemir Manisa City Hospital, Department of Cardiology Adnan Menderes Mh. 132.Sokak No : 15 45040 Şehzadeler, Manisa E-mail: dr.ibrahimhalilozdemir@gmail.com

References

  • Chen, L, Liu, W, Zhang, Q, et al., RNA based mNGS approach identifies a novel human coronavirus from two individual pneumonia cases in 2019 Wuhan outbreak, Emerging microbes & infections, 2020, 9(1), 313-319.
  • Zhu, N, Zhang, D, Wang, W, et al., A Novel Coronavirus from Patients with Pneumonia in China, 2019, The New England journal of medicine, 2020, 382(8), 727-733.
  • Mahase, E, Covid-19: WHO declares pandemic because of "alarming levels" of spread, severity, and inaction, BMJ (Clinical research ed), 2020, 368, m1036.
  • Wang, D, Hu, B, Hu, C, et al., Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China, JAMA, 323(11), 1061–1069.
  • Huang, C, Wang, Y, Li, X, et al., Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China, Lancet, 2020, 395(10223), 497-506.
  • Inciardi, R.M, Adamo, M, Lupi, L, et al., Characteristics and outcomes of patients hospitalized for COVID-19 and cardiac disease in Northern Italy, European heart journal, 2020, 41(19), 1821-1829.
  • Fumagalli, S, Salani, B, Gabbani, L, Mossello, E, Ungar, A, Covid-19 cases in a no-Covid-19 geriatric acute care setting, A sporadic occurrence? European journal of internal medicine, 2020, 77, 141-142.
  • Barón-Esquivias, G, Manito, N, López Díaz, J, et al., Update for 2014 on clinical cardiology, geriatric cardiology, and heart failure and transplantation, Revista espanola de cardiologia (English ed), 2015, 68(4), 317-323.
  • January, C.T, Wann, L.S, Alpert, J.S, et al., American College of Cardiology/American Heart Association Task Force on Practice Guidelines, 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society, Journal of American College of Cardiology, 2014, 64(21), e1-76.
  • Chen, L.Y, Sotoodehnia, N, Bůžková, P, et al., Atrial fibrillation and the risk of sudden cardiac death: the atherosclerosis risk in communities study and cardiovascular health study, JAMA internal medicine, 2013, 173(1), 29-35.
  • Chen, N, Zhou, M, Dong, X, et al., Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study, Lancet, 2020, 395(10223), 507-513.
  • Tang, N, Li, D, Wang, X, et al., Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia, Journal of Thrombosis Haemostasis, 2020, 18(4), 844-847.
  • Shanghai Clinical Treatment Expert Group for Corona Virus Disease 2019, Comprehensive treatment and management of corona virus disease 2019: expert consensus statement from Shanghai [J], Chinese Journal of Infectious Diseases, 2020, 38 (00), E016-E016.
  • Thachil, J, Tang, N, Gando, S, et al., ISTH interim guidance on recognition and management of coagulopathy in COVID-19, Journal of thrombosis and haemostasis : JTH, 2020, 18(5), 1023-1026.
  • Sünmez, S, Okumuş, G, Kiyan, E, Ece, T, Arseven, O, [A case of heparin induced thrombocytopenia treated with lepirudin infusion: case report], Tuberkuloz ve toraks, 2006, 54(2), 185-188.
  • Thachil, J, Tang, N, Gando, S, et al., DOACs and "newer" hemophilia therapies in COVID-19: Reply, Journal of thrombosis and haemostasis, 2020, 18(7), 1795-1796.
  • Testa, S, Paoletti, O, Giorgi-Pierfranceschi, M, Pan, A, Switch from oral anticoagulants to parenteral heparin in SARS-CoV-2 hospitalized patients, Internal and emergency medicine, 2020, 15(5), 751-753.
  • Zhang, L, Yan, X, Fan, Q, et al., D-dimer levels on admission to predict in-hospital mortality in patients with Covid-19, Journal of thrombosis and haemostasis : JTH. 2020, 18(6), 1324-1329.
  • Horby, P, Lim, W.S, Emberson, J.R, et al., Dexamethasone in Hospitalized Patients with Covid-19 - Preliminary Report, The New England journal of medicine, 2020.

Antikoagülan Tedavi ve COVID-19

Year 2022, Volume: 9 Issue: 1, 106 - 111, 31.03.2022
https://doi.org/10.34087/cbusbed.1007918

Abstract

Giriş ve Amaç: Bu çalışmada, atriyal fibrilasyonun (AF) COVID-19 hastalarında mortaliteye etkisini ve riskli AF hastalarının belirlenmesinde kullanılabilicek risk skorlarını incelemeyi amaçladık. Bunun yanında oral antikoagülan kullanımın tedavideki yerini incelemeyi amaçladık.
Gereç ve Yöntemler: COVID-19 tanısı almış hastaların kayıtları retrospektif olarak incelendi. Bu hastalar içinden AF tanısı olan 48 hasta belirlendi. Hastaların yoğun bakım ihtiyacı, mortalitesi, CHA2DS2VASC ve HAS-BLED skorları kaydedildi. CRP ve D-Dimer düzeyleri kaydedildi. Hastaların kullanmış oldukları oral antikoagülan tedaviler kayıt altına alındı.
Bulgular: Yoğun bakım ünitesinde takip edilen hastaların CHA2DS2VASC (yoğun bakım: 4,50±1,41, dahiliye servisi: 2,50±1,05, p<0,05) ve HAS-BLED (yoğun bakım: 2,0±1,08, dahiliye servisi: 1,5±0,77, p<0,05) skorları daha yüksekti. Hayatını kaybeden atriyal fibrilasyonlu hastalar daha yüksek CRP (hayatta kalan: 21,50 ± 15,23, hayatta kalmayan: 142,30 ± 48,49, p <0,05) ve D-Dimer (hayatta kalan: 183,47 ± 43,68, hayatta kalmayan: 878,98 ± 112,24, p <0,05) değerlerine sahipti. Hastaların 24’ü kullanmış olduğu oral antikoagülana devam ederken 24’ü düşük molekül ağrlıklı heparin (DMAH) kullanmış. Bu hastaların hiçbirinde kanama saptanmadı. Eritrosit replasmanı gerektiren anemi iki grup arasında benzerdi (oral antikoaülan: 2 (8,3%), DMAH: 3 (12,5%), p:0,152). Mortalite her iki grup arasında benzerdi (oral antikoaülan: 5 (20,8%), DMAH: 5 (20,8%), p:0,248).
Sonuç: AF, COVID-19'da mortaliteyi etkileyen önemli bir kardiyovasküler risk faktörüdür. Riskli hastaların belirlenmesinde CHA2DS2VASC ve HAS-BLED skorları önemlidir. CRP ve D-Dimer, riskli AF hastalarının belirlenmesinde önemli laboratuvar parametreleridir. Hastaların kullanmış oldukları antikoagülan tedaviler COVID-19 tedavisinde önerilen DMAH yerine düşünülebilir.

Project Number

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References

  • Chen, L, Liu, W, Zhang, Q, et al., RNA based mNGS approach identifies a novel human coronavirus from two individual pneumonia cases in 2019 Wuhan outbreak, Emerging microbes & infections, 2020, 9(1), 313-319.
  • Zhu, N, Zhang, D, Wang, W, et al., A Novel Coronavirus from Patients with Pneumonia in China, 2019, The New England journal of medicine, 2020, 382(8), 727-733.
  • Mahase, E, Covid-19: WHO declares pandemic because of "alarming levels" of spread, severity, and inaction, BMJ (Clinical research ed), 2020, 368, m1036.
  • Wang, D, Hu, B, Hu, C, et al., Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China, JAMA, 323(11), 1061–1069.
  • Huang, C, Wang, Y, Li, X, et al., Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China, Lancet, 2020, 395(10223), 497-506.
  • Inciardi, R.M, Adamo, M, Lupi, L, et al., Characteristics and outcomes of patients hospitalized for COVID-19 and cardiac disease in Northern Italy, European heart journal, 2020, 41(19), 1821-1829.
  • Fumagalli, S, Salani, B, Gabbani, L, Mossello, E, Ungar, A, Covid-19 cases in a no-Covid-19 geriatric acute care setting, A sporadic occurrence? European journal of internal medicine, 2020, 77, 141-142.
  • Barón-Esquivias, G, Manito, N, López Díaz, J, et al., Update for 2014 on clinical cardiology, geriatric cardiology, and heart failure and transplantation, Revista espanola de cardiologia (English ed), 2015, 68(4), 317-323.
  • January, C.T, Wann, L.S, Alpert, J.S, et al., American College of Cardiology/American Heart Association Task Force on Practice Guidelines, 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society, Journal of American College of Cardiology, 2014, 64(21), e1-76.
  • Chen, L.Y, Sotoodehnia, N, Bůžková, P, et al., Atrial fibrillation and the risk of sudden cardiac death: the atherosclerosis risk in communities study and cardiovascular health study, JAMA internal medicine, 2013, 173(1), 29-35.
  • Chen, N, Zhou, M, Dong, X, et al., Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study, Lancet, 2020, 395(10223), 507-513.
  • Tang, N, Li, D, Wang, X, et al., Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia, Journal of Thrombosis Haemostasis, 2020, 18(4), 844-847.
  • Shanghai Clinical Treatment Expert Group for Corona Virus Disease 2019, Comprehensive treatment and management of corona virus disease 2019: expert consensus statement from Shanghai [J], Chinese Journal of Infectious Diseases, 2020, 38 (00), E016-E016.
  • Thachil, J, Tang, N, Gando, S, et al., ISTH interim guidance on recognition and management of coagulopathy in COVID-19, Journal of thrombosis and haemostasis : JTH, 2020, 18(5), 1023-1026.
  • Sünmez, S, Okumuş, G, Kiyan, E, Ece, T, Arseven, O, [A case of heparin induced thrombocytopenia treated with lepirudin infusion: case report], Tuberkuloz ve toraks, 2006, 54(2), 185-188.
  • Thachil, J, Tang, N, Gando, S, et al., DOACs and "newer" hemophilia therapies in COVID-19: Reply, Journal of thrombosis and haemostasis, 2020, 18(7), 1795-1796.
  • Testa, S, Paoletti, O, Giorgi-Pierfranceschi, M, Pan, A, Switch from oral anticoagulants to parenteral heparin in SARS-CoV-2 hospitalized patients, Internal and emergency medicine, 2020, 15(5), 751-753.
  • Zhang, L, Yan, X, Fan, Q, et al., D-dimer levels on admission to predict in-hospital mortality in patients with Covid-19, Journal of thrombosis and haemostasis : JTH. 2020, 18(6), 1324-1329.
  • Horby, P, Lim, W.S, Emberson, J.R, et al., Dexamethasone in Hospitalized Patients with Covid-19 - Preliminary Report, The New England journal of medicine, 2020.
There are 19 citations in total.

Details

Primary Language English
Subjects Cardiovascular Surgery
Journal Section Araştırma Makalesi
Authors

İbrahim Halil Özdemır 0000-0003-3953-4387

Mehmet Burak Özen 0000-0002-9499-3466

Ramazan Gündüz 0000-0001-7133-4604

Project Number yok
Publication Date March 31, 2022
Published in Issue Year 2022 Volume: 9 Issue: 1

Cite

APA Özdemır, İ. H., Özen, M. B., & Gündüz, R. (2022). Anticoagulant treatment and COVID-19. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, 9(1), 106-111. https://doi.org/10.34087/cbusbed.1007918
AMA Özdemır İH, Özen MB, Gündüz R. Anticoagulant treatment and COVID-19. CBU-SBED: Celal Bayar University-Health Sciences Institute Journal. March 2022;9(1):106-111. doi:10.34087/cbusbed.1007918
Chicago Özdemır, İbrahim Halil, Mehmet Burak Özen, and Ramazan Gündüz. “Anticoagulant Treatment and COVID-19”. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 9, no. 1 (March 2022): 106-11. https://doi.org/10.34087/cbusbed.1007918.
EndNote Özdemır İH, Özen MB, Gündüz R (March 1, 2022) Anticoagulant treatment and COVID-19. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 9 1 106–111.
IEEE İ. H. Özdemır, M. B. Özen, and R. Gündüz, “Anticoagulant treatment and COVID-19”, CBU-SBED: Celal Bayar University-Health Sciences Institute Journal, vol. 9, no. 1, pp. 106–111, 2022, doi: 10.34087/cbusbed.1007918.
ISNAD Özdemır, İbrahim Halil et al. “Anticoagulant Treatment and COVID-19”. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 9/1 (March 2022), 106-111. https://doi.org/10.34087/cbusbed.1007918.
JAMA Özdemır İH, Özen MB, Gündüz R. Anticoagulant treatment and COVID-19. CBU-SBED: Celal Bayar University-Health Sciences Institute Journal. 2022;9:106–111.
MLA Özdemır, İbrahim Halil et al. “Anticoagulant Treatment and COVID-19”. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, vol. 9, no. 1, 2022, pp. 106-11, doi:10.34087/cbusbed.1007918.
Vancouver Özdemır İH, Özen MB, Gündüz R. Anticoagulant treatment and COVID-19. CBU-SBED: Celal Bayar University-Health Sciences Institute Journal. 2022;9(1):106-11.