核心概念
Comparing clinical outcomes of prophylactic vs. therapeutic anticoagulation in hospitalized COVID-19 patients.
摘要
Abstract and Introduction:
- Studies show benefits of anticoagulation in COVID-19 patients.
- Controversy exists over the optimal anticoagulant dosage.
- Study in Ethiopia compares outcomes of prophylactic vs. therapeutic anticoagulation.
Methods:
- Retrospective cohort study on hospitalized COVID-19 patients.
- Primary outcome: in-hospital mortality.
- Subgroup analyses for critical and severe COVID-19 patients.
Results:
- 472 patients included, split between prophylactic and therapeutic anticoagulation.
- Therapeutic dose linked to higher inpatient mortality in critical patients.
- No significant association between anticoagulation dosage and mortality in severe patients.
- Incidence of thrombosis slightly lower in therapeutic group for severe patients.
- Major bleeding events only in therapeutic group, statistically significant.
Conclusion:
- Results contradict current recommendations on anticoagulation dosage for COVID-19 patients.
- Calls for randomized controlled trials in resource-limited settings.
統計資料
A total of 472 hospitalized COVID-19 patients were included in this study.
49.8% received therapeutic anticoagulation, and 50.2% received prophylactic dose.
In critical COVID-19 subgroup, therapeutic dose was associated with higher inpatient mortality (AOR 2.27, 95% CI, 1.18—4.35, p = 0.013).
In severe COVID-19 subgroup, anticoagulation dosage was not associated with inpatient mortality (OR, 1.02, 95% CI, 0.45 – 2.33, p = 0.958).
Incidence of thrombosis was slightly lower in the therapeutic group for severe COVID-19 patients (AOR 0.15, 95% CI, 0.02 – 1.20, p = 0.073).
All six major bleeding events were recorded in patients in the therapeutic subgroup, statistically significant (p = 0.013).
引述
"Our results are not consistent with current recommendations on anti-coagulation dose for hospitalized patients with COVID-19."