About: Clinical Outcomes of Hospitalized Patients with COVID-19 on Therapeutic Anticoagulants

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	Clinical Outcomes of Hospitalized Patients with COVID-19 on Therapeutic Anticoagulants
Creator	Barsuk, Jeffrey Angarone, Michael Belknap, Steven Bhasin, Ajay Cohen, Elaine Feinglass, Joseph Patel, Niti
Source	MedRxiv
abstract	Background: COVID-19 is associated with hypercoagulability and an increased incidence of thrombosis. We evaluated the clinical outcomes of adults hospitalized with COVID-19 who either continued therapeutic anticoagulants previously prescribed or who were newly started on anticoagulants during hospitalization. Methods: We performed an observational study of adult inpatients with COVID-19 at 10 hospitals affiliated with Northwestern Medicine in the Chicagoland area from March 9 to June 26, 2020. We evaluated clinical outcomes of subjects with COVID-19 who were continued on their outpatient therapeutic anticoagulation during hospitalization and those who were newly started on these medications compared to those who were on prophylactic doses of these medications based on the World Health Organization (WHO) Ordinal Scale for Clinical Improvement. The primary outcome was overall death while secondary outcomes were critical illness (WHO score >5), need for mechanical ventilation, and death among those subjects who first had critical illness adjusted for age, sex, race, body mass index (BMI), Charlson score, glucose on admission, and use of antiplatelet agents. Results: 1,716 subjects with COVID-19 were included in the analysis. 171 subjects (10.0%) were continued on their outpatient therapeutic anticoagulation and 201(11.7%) were started on new therapeutic anticoagulation during hospitalization. In subjects continued on home therapeutic anticoagulation, there were no differences in overall death, critical illness, mechanical ventilation, or death among subjects with critical illness compared to subjects on prophylactic anticoagulation. Subjects receiving new therapeutic anticoagulation for COVID-19 were more likely to die (OR 5.93; 95% CI 3.71-9.47), have critical illness (OR 14.51; 95% CI 7.43-28.31), need mechanical ventilation (OR 11.22; 95% CI 6.67-18.86), and die after first having critical illness. (OR 5.51; 95% CI 2.80 -10.87). Conclusions: Continuation of outpatient prescribed anticoagulant was not associated with improved clinical outcomes. Therapeutic anticoagulation for COVID-19 in absence of other indications was associated with worse clinical outcomes.
has issue date	2020-08-26(xsd:dateTime)
bibo:doi	10.1101/2020.08.22.20179911
has license	medrxiv
sha1sum (hex)	239409b918102d3518470bd6bb133d636297591f
schema:url	https://doi.org/10.1101/2020.08.22.20179911
resource representing a document's title	Clinical Outcomes of Hospitalized Patients with COVID-19 on Therapeutic Anticoagulants
resource representing a document's body	covid:239409b918102d3518470bd6bb133d636297591f#body_text
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