In-Hospital Clinical Outcomes of Covid-19 Patients Treated with Oral Anticoagulants

Abstract

Objective: We aimed to investigate the effects of warfarin and new-generation oral anticoagulants on the prognosis of patients diagnosed with coronavirus disease 2019 (COVID-19). Materials and Methods: Patients diagnosed with COVID-19 were divided into two groups depending on whether they were using warfarin or a new-generation oral anticoagulant. The types of chronic diseases, drugs used, hematological and biochemical parameters, and prognoses in each group were statistically analysed. Results: Twenty-three patients (37.1%) using warfarin and 39 (62.9%) patients using new-generation oral anticoagulants were included in the study. There was no significant difference between the two groups regarding demographic characteristics and laboratory data. The mortality rates for the warfarin and new-generation anticoagulant groups were similar (39.1% vs. 43.6%, respectively; p = 0.731). Also, there was no significant difference in the results of major bleeding and intubation rates between the two groups. Conclusion: There was no difference in the effects of warfarin and new-generation oral anticoagulants on mortality, intubation and major bleeding among the patients with COVID-19.

Keywords

• Anticoagulation
• coronavirus
• Covid-19
• thrombosis

Oral Antikoagülan Kullanan Covid-19 Hastalarının Hastane İçi Klinik Sonuçları

Abstract

Amaç: Çalışmamızda varfarin ve yeni nesil oral antikoagülanların COVID-19 hastalığının prognozu üzerine etkilerini araştırmayı amaçladık. Materyal ve Metot: COVID-19 tanısı alan hastalar, varfarin veya yeni nesil oral antikoagülan kullanıp kullanmamalarına göre iki gruba ayrıldı. Her gruptaki kronik hastalık tipleri, kullanılan ilaçlar, hematolojik ve biyokimyasal parametreler ve prognozlar istatistiksel olarak analiz edildi. Bulgular: Varfarin kullanan 23 (%37,1) hasta ve yeni nesil oral antikoagülan kullanan 39 (%62,9) hasta çalışmaya dahil edildi. Her iki grup arasında demografik özellikler ve laboratuvar verileri açısından anlamlı fark yoktu. Varfarin ve yeni nesil antikoagülan gruplarında mortalite oranları benzerdi (sırasıyla %39,1 ve %43,6; p = 0,731). Ayrıca majör kanama ve entübasyon oranları sonuçlarında da iki grup arasında anlamlı fark yoktu. Sonuç: COVID-19 hastalarında varfarin ve yeni nesil oral antikoagülanların entübasyon, majör kanama ve mortalite üzerine etkileri arasında fark yoktu.

Keywords

• Antikoagülasyon
• Covid-19
• koronavirüs
• tromboz

References

1. Tian S, Hu N, Lou J, et al. Characteristics of COVID-19 infection in Beijing. J Infect. 2020;80(4):401-406. doi:10.1016/j.jinf.2020.02.018
2. Coronavirus disease (COVID-19). https://www.who.int/health-topics/coronavirus#tab=tab_1. February 11, 2020.
3. Madabhavi I, Sarkar M, Kadakol N. COVID-19: a review. Monaldi Arch Chest Dis. 2020;14:90(2). doi:10.4081/monaldi.2020.1298
4. Tang N, Li D, Wang X, Ziyong Sun. Abnormal Coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost. 2020;18:844-847. doi:10.1111/jth.14768
5. Kow CS, Sunter W, Bain A, Syed Tabish Razi Zaidi, Syed Shahzad Hasan. Management of outpatient warfarin therapy amid COVID-19 pandemic: A practical guide. Am J Cardiovasc Drugs. 2020;26:1-9. doi:10.1007/s40256-020-00415-z
6. Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The Lancet. 2020;395:1054-62. doi:10.1016/S0140-6736(20)30566-3
7. Wang Y, Wang Y, Chen Y, Qin Q.Unique epidemiological and clinical features of the emerging 2019 novel coronavirus pneumonia (COVID-19) implicate special control measures. J Med Virol. 2020;92(6):568-576. doi:10.1002/jmv.25748
8. Frater JL, Zini G, d'Onofrio G, Heesun J Rogers . COVID-19 and the clinical hematology laboratory .Int J Lab Hematol. 2020;42(1):11-18. DOI: 10.1111/ijlh.13229

9. Levi M,Tachil J, Iba T, Jerrold H Levy . Coagulation abnormalities and thrombosis in patients with COVID-19. Lancet Haematol. 2020;7(6):e438-e440. doi:10.1016/S2352-3026(20)30145-30149.
10. Subramaniam S, Scharrer I. Procoagulant activity during viral infections. Front Biosci (Landmark Ed). 2018;23:1060-1081. doi:10.2741/4633
11. Price LC, McCabe C, Garfield B, Stephen J Wort . Thrombosis and COVID-19 pneumonia: the clot thickens! Eur Respir J. 2020;56(1):2001608. doi:10.1183/13993003.01608-2020
12. Connors JM, Jerrold HL. COVID-19 and its implications for thrombosis and anticoagulation. Blood. 2020;135(23):2033-2040. doi:10.1182/blood.2020006000
13. Fox SE, Akmatbekov A, Harbert JL, et al. Pulmonary and cardiac pathology in Covid-19: The first autopsy series from New Orleans. Lancet Respir Med. 2020; 8(7):681-686. doi:10.1016/S2213-2600(20)30243-5
14. N. Tang, D. Li, X. Wang, Z. Sun, Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia, J Thromb Haemost 2020;18(4):844–847. doı:10.1111/jth.14768