Abstract:
:Thrombotic complications occur at high rates in hospitalized patients with COVID-19, yet the impact of intensive antithrombotic therapy on mortality is uncertain. We examined in-hospital mortality with intermediate- compared to prophylactic-dose anticoagulation, and separately with in-hospital aspirin compared to no antiplatelet therapy, in a large, retrospective study of 2785 hospitalized adult COVID-19 patients. In this analysis, we established two separate, nested cohorts of patients (1) who received intermediate- or prophylactic-dose anticoagulation ("anticoagulation cohort", N = 1624), or (2) who were not on home antiplatelet therapy and received either in-hospital aspirin or no antiplatelet therapy ("aspirin cohort", N = 1956). To minimize bias and adjust for confounding factors, we incorporated propensity score matching and multivariable regression utilizing various markers of illness severity and other patient-specific covariates, yielding treatment groups with well-balanced covariates in each cohort. The primary outcome was cumulative incidence of in-hospital death. Among propensity score-matched patients in the anticoagulation cohort (N = 382), in a multivariable regression model, intermediate- compared to prophylactic-dose anticoagulation was associated with a significantly lower cumulative incidence of in-hospital death (hazard ratio 0.518 [0.308-0.872]). Among propensity-score matched patients in the aspirin cohort (N = 638), in a multivariable regression model, in-hospital aspirin compared to no antiplatelet therapy was associated with a significantly lower cumulative incidence of in-hospital death (hazard ratio 0.522 [0.336-0.812]). In this propensity score-matched, observational study of COVID-19, intermediate-dose anticoagulation and aspirin were each associated with a lower cumulative incidence of in-hospital death. This article is protected by copyright. All rights reserved.
journal_name
Am J Hematoljournal_title
American journal of hematologyauthors
Meizlish ML,Goshua G,Liu Y,Fine R,Amin K,Chang E,DeFilippo N,Keating C,Liu Y,Mankbadi M,McManus D,Wang SY,Price C,Bona RD,Ochoa Chaar CI,Chun HJ,Pine AB,Rinder HM,Siner JM,Neuberg DS,Owusu KA,Lee AIdoi
10.1002/ajh.26102subject
Has Abstractpub_date
2021-01-21 00:00:00eissn
0361-8609issn
1096-8652pub_type
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journal_title:American journal of hematology
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