Effect of Anticoagulant Administration on the Mortality of Hospitalized Patients With COVID-19: An Updated Systematic Review and Meta-Analysis

Frontiers in Medicine

Luojia Jiang¹  Heyue Du²  Zheng Qin²  Yupei Li³  Baihai Su⁴ 

[1] Department of Nephrology, Jiujiang No. 1 People's Hospital, Jiujiang, China;Department of Nephrology, West China Hospital, Sichuan University, Chengdu, China;Disaster Medicine Center, Institute for Disaster Management and Reconstruction, Sichuan University, Chengdu, China;Med-X Center for Materials, Sichuan University, Chengdu, China;The First People's Hospital of Shuangliu District, Chengdu, China;

关键词: anticoagulation;    coronavirus disease 2019;    heparin;    mortality;    bleeding;   

DOI  :  10.3389/fmed.2021.698935

来源: DOAJ

【 摘 要 】

Background: Anticoagulation is generally used in hospitalized patients with coronavirus disease 2019 (COVID-19) as thromboprophylaxis. However, results from different studies comparing the effect of anticoagulation on the mortality of COVID-19 patients with non-anticoagulation are inconclusive.Methods: Our systematic review included observational trials if they studied anticoagulant therapy in hospitalized patients with COVID-19 for mortality or bleeding events. Dichotomous variables from individual studies were pooled by risk ratio (RR) and their 95% confidence interval (95% CI) using the random-effects model. Grading of Recommendations Assessment, Development and Evaluation was used to assess the quality of evidence.Results: A total of 11 observational studies enrolling 20,748 hospitalized COVID-19 patients overall were included. A pooled meta-analysis of these studies showed that anticoagulation therapy, compared with non-anticoagulation therapy, was associated with lower mortality risk (RR 0.70, 95% CI 0.52–0.93, p = 0.01). The evidence of benefit was stronger among critically ill COVID-19 patients in the intensive care units (RR 0.59, 95% CI 0.43–0.83, p = 0.002). Additionally, severe bleeding events were not associated with the administration of anticoagulants (RR 0.93, 95% CI 0.71–1.23, p = 0.63).Conclusion: Among patients with COVID-19 admitted to hospital, the administration of anticoagulants was associated with a decreased mortality without increasing the incidence of bleeding events.

【 授权许可】

Unknown