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oai:docta.ucm.es:20.500.14352/998422025-03-18T15:22:07Zcom_20.500.14352_14col_20.500.14352_15

00925njm 22002777a 4500 dc Rivera Caravaca, José Miguel author Nuñez Gil, I. J. author Vivas Balcones, Luis David author Macaya Miguel, Carlos author Fernández Ortiz, Antonio Ignacio author Estrada Pérez, Vicente author 2021-01-01 Estudio observacional donde se compararon en 1.002 pacientes con COVID-19 durante la primera ola de la pandemia el efecto del tratamiento anticoagulante previo sobre la mortalidad intrahospitalaria. El estudio concluyó que los pacientes hospitalizados con COVID-19 y que tomaban previamente anticoagulación presentaron menor supervivencia y muchas más comorbilidades. Background The coronavirus disease 2019 (COVID-19) shows high morbidity and mortality, particularly in patients with concomitant cardiovascular diseases. Some of these patients are under oral anticoagulation (OAC) at admission, but to date, there are no data on the clinical profile, prognosis and risk factors of such patients during hospitalization for COVID-19. Design Subanalysis of the international ‘real-world’ HOPE COVID-19 registry. All patients with prior OAC at hospital admission for COVID-19 were suitable for the study. All-cause mortality was the primary endpoint. Results From 1002 patients included, 110 (60.9% male, median age of 81.5 [IQR 75-87] years, median Short-Form Charlson Comorbidity Index [CCI] of 1 [IQR 1-3]) were on OAC at admission, mainly for atrial fibrillation and venous thromboembolism. After propensity score matching, 67.9% of these patients died during hospitalization, which translated into a significantly higher mortality risk compared to patients without prior OAC (HR 1.53, 95% CI 1.08-2.16). After multivariate Cox regression analysis, respiratory insufficiency during hospitalization (HR 6.02, 95% CI 2.18-16.62), systemic inflammatory response syndrome (SIRS) during hospitalization (HR 2.29, 95% CI 1.34-3.91) and the Short-Form CCI (HR 1.24, 95% CI 1.03-1.49) were the main risk factors for mortality in patients on prior OAC. Conclusions Compared to patients without prior OAC, COVID-19 patients on OAC therapy at hospital admission showed lower survival and higher mortality risk. In these patients on OAC therapy, the prevalence of several comorbidities is high. Respiratory insufficiency and SIRS during hospitalization, as well as higher comorbidity, pointed out those anticoagulated patients with increased mortality risk. Rivera-Caravaca JM, Nuñez-Gil IJ, Vivas D, Viana-Llamas MC, Uribarri A, Becerra-Muñoz VM, et al. Clinical profile and prognosis in patients on oral anticoagulation before admission for COVID-19. Eur J Clin Invest. 2021;51:e13436 10.1111/eci.13436 https://hdl.handle.net/20.500.14352/99842 https://onlinelibrary.wiley.com/doi/10.1111/eci.13436 33080051 33080051 https://pubmed.ncbi.nlm.nih.gov/33080051/ Clinical profile and prognosis in patients on oral anticoagulation before admission for COVID-19