Association of Treatment Dose Anticoagulation With In-Hospital Survival Among Hospitalized Patients With COVID-19

Association of Treatment Dose Anticoagulation With In-Hospital Survival Among Hospitalized Patients With COVID-19

VOL. 76, NO. 1, 2020 | Ishan Paranjpe, BS; Valentin Fuster, MD, PhD; Anuradha Lala, MD; Adam J. Russak, MD; Benjamin S. Glicksberg, PhD; Matthew A. Levin, MD; Alexander W. Chaney, MD, PhD; Jagat Narula, MD, PhD; Zahi A. Fayad, PhD; Emilia Bagiella, PhD; Shan Zhao, MD, PhD; Girish N. Nadkarni, MD, MPH
Since January 2020, Elsevier has established a COVID-19 resource center on Elsevier Connect, providing free information in English and Mandarin about the novel coronavirus. Elsevier grants permission to make all COVID-19-related research available in PubMed Central and other public repositories, with unrestricted reuse and analysis rights, as long as the resource center remains active. A study by researchers from the Icahn School of Medicine at Mount Sinai assessed the association between in-hospital administration of systemic anticoagulation (AC) and survival in hospitalized patients with COVID-19. Between March 14 and April 11, 2020, 2,773 patients were hospitalized with confirmed COVID-19. The study found that 28% of patients received treatment-dose AC, which was associated with a slightly higher in-hospital mortality rate (22.5%) compared to those who did not receive AC (22.8%). However, patients who received AC were more likely to require invasive mechanical ventilation. In a multivariate model, longer AC treatment duration was associated with a reduced risk of mortality. The study also explored the association between AC and bleeding events, finding that while bleeding events were more common among intubated patients, they were not significantly different between those who received AC and those who did not. Another study from the Central Hospital of Wuhan, China, investigated the association between acute myocardial injury at admission and all-cause mortality in COVID-19 patients. The study included 179 patients, with 116 survivors and 60 nonsurvivors. Acute myocardial injury was significantly associated with increased risk of death, with a crude odds ratio of 10.20 and an adjusted odds ratio of 6.93. The findings highlight the importance of monitoring myocardial enzymes, cardiac rhythm, and functions in patients with COVID-19.Since January 2020, Elsevier has established a COVID-19 resource center on Elsevier Connect, providing free information in English and Mandarin about the novel coronavirus. Elsevier grants permission to make all COVID-19-related research available in PubMed Central and other public repositories, with unrestricted reuse and analysis rights, as long as the resource center remains active. A study by researchers from the Icahn School of Medicine at Mount Sinai assessed the association between in-hospital administration of systemic anticoagulation (AC) and survival in hospitalized patients with COVID-19. Between March 14 and April 11, 2020, 2,773 patients were hospitalized with confirmed COVID-19. The study found that 28% of patients received treatment-dose AC, which was associated with a slightly higher in-hospital mortality rate (22.5%) compared to those who did not receive AC (22.8%). However, patients who received AC were more likely to require invasive mechanical ventilation. In a multivariate model, longer AC treatment duration was associated with a reduced risk of mortality. The study also explored the association between AC and bleeding events, finding that while bleeding events were more common among intubated patients, they were not significantly different between those who received AC and those who did not. Another study from the Central Hospital of Wuhan, China, investigated the association between acute myocardial injury at admission and all-cause mortality in COVID-19 patients. The study included 179 patients, with 116 survivors and 60 nonsurvivors. Acute myocardial injury was significantly associated with increased risk of death, with a crude odds ratio of 10.20 and an adjusted odds ratio of 6.93. The findings highlight the importance of monitoring myocardial enzymes, cardiac rhythm, and functions in patients with COVID-19.
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[slides and audio] Association of Treatment Dose Anticoagulation With In-Hospital Survival Among Hospitalized Patients With COVID-19