Nutritional Advice El Mondo
Objectives:
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. Therefore, this review article has been conducted.
Does anticoagulant therapy in hospitalized patients with COVID-19 decrease mortality or bleeding events?
Study design:
This review article included 11 observational studies enrolling 20,748 hospitalized COVID-19 patients with reported information related to mortality and a pooled sample of 11,302 patients with reported information related to bleeding events.
The sample sizes ranged widely across studies from 81 to 4,389.
All studies were retrospective in study design.
The mean age in most studies was over 60 years. The proportion of male subjects ranged from 47 to 69%.
Heparin and enoxaparin were the most used anticoagulants in the included studies.
Begg's rank correlation test did not indicate the evidence of publication bias across studies of anticoagulant therapy in COVID-19 patients and mortality [p = 0.213].
Results and conclusions:
The investigators found pooled meta-analysis showed that anticoagulation therapy, compared with non-anticoagulation therapy, was significantly associated with a lower mortality risk of 30% [RR = 0.70, 95% CI = 0.52 to 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 to 0.83, p = 0.002].
The investigators found, additionally, severe bleeding events were not associated with the administration of anticoagulants [RR = 0.93, 95% CI = 0.71 to 1.23, p = 0.63].
The investigators concluded that among patients with COVID-19 admitted to hospital, the administration of anticoagulants is associated with a decreased mortality without increasing the incidence of bleeding events. However, pragmatic trials and well-designed RCT studies with longer follow-up duration and larger sample size are warranted to further investigate the effect of anticoagulant therapy on the mortality of hospitalized COVID-19 patients in the real-world practice.
Original title:
Effect of Anticoagulant Administration on the Mortality of Hospitalized Patients With COVID-19: An Updated Systematic Review and Meta-Analysis by Jiang L, Li Y, […], Su B.
Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8371681/
Additional information of El Mondo:
Find more information/studies on coronavirus right here.