Direct-acting oral anticoagulants use prior to COVID-19 diagnosis and associations with 30-day clinical outcomes

It is unclear if direct-acting oral anticoagulants (DOACs) use before hospitalization due to COVID-19 diagnosis would potentially impact the severity and clinical outcomes thereafter. We compared 30-day hospitalization/re-hospitalization and clinical outcomes between patients on chronic DOAC therapy...

Full description

Saved in:
Bibliographic Details
Published in:Thrombosis research 2021-09, Vol.205, p.1-7
Main Authors: Rivera-Caravaca, José Miguel, Buckley, Benjamin J.R., Harrison, Stephanie L., Fazio-Eynullayeva, Elnara, Underhill, Paula, Marín, Francisco, Lip, Gregory Y.H.
Format: Article
Language:English
Subjects:
Administration, Oral
Adolescent
Adult
Aged
Aged, 80 and over
Anticoagulant
Anticoagulants - therapeutic use
Bleeding
Coronavirus disease 2019
COVID-19
COVID-19 Testing
Direct-acting oral anticoagulants
Factor Xa Inhibitors - therapeutic use
Female
Full Length
Humans
Male
Middle Aged
Mortality
SARS-CoV-2
Thrombosis
Venous Thromboembolism - drug therapy
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:It is unclear if direct-acting oral anticoagulants (DOACs) use before hospitalization due to COVID-19 diagnosis would potentially impact the severity and clinical outcomes thereafter. We compared 30-day hospitalization/re-hospitalization and clinical outcomes between patients on chronic DOAC therapy and patients not on oral anticoagulation (OAC) therapy at time of COVID-19 diagnosis. We used data from TriNetX, a global federated health research network. Patients aged ≥18 years who were treated with DOACs at time of COVID-19 diagnosis between 20 January 2020 and 28 February 2021 were included, and matched with patients not on OAC therapy from the same period. All patients were followed-up at 30-days after COVID-19 diagnosis. The primary outcomes were all-cause mortality, hospitalization/re-hospitalization, venous thromboembolism (VTE) and intracranial hemorrhage (ICH). 738,423 patients were included. After propensity score matching (PSM), 26,006 patients remained in the study (13,003 on DOACs; 13,003 not on OAC). DOAC-treated patients (mean age 67.1 ± 15.4 years, 52.2% male) had higher relative risks (RRs) and lower 30-days event-free survival as compared to patients not on OAC for all-cause mortality (RR 1.27, 95% CI 1.12–1.44; Log-Rank test p = 0.010), hospitalization/re-hospitalization (RR 1.72, 95% CI 1.64–1.82; Log-Rank test p 
ISSN:0049-3848
1879-2472
DOI:10.1016/j.thromres.2021.06.014