1. Safety and Efficacy Analysis of Apixaban Compared to Heparins in Hospitalized Non-Critically Ill COVID-19 Patients.
- Author
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Appiah, Daniel, Quinn, Nicholas J., Messing, Emily G., and Veltri, Keith T.
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HEMORRHAGE prevention , *DRUG efficacy , *ENOXAPARIN , *LIVER function tests , *COVID-19 , *VEINS , *ACADEMIC medical centers , *CONFIDENCE intervals , *HEMOGLOBINS , *ANTICOAGULANTS , *RETROSPECTIVE studies , *FISHER exact test , *T-test (Statistics) , *HOSPITAL care , *LOW-molecular-weight heparin , *DESCRIPTIVE statistics , *CHI-squared test , *STATISTICAL hypothesis testing , *HEPARIN , *DATA analysis software , *ALANINE aminotransferase , *ASPARTATE aminotransferase , *COMORBIDITY ,THROMBOEMBOLISM prevention - Abstract
Purpose: Heparin-based regimens are recommended for anticoagulation in hospitalized patients with COVID-19 though a study reported similar mortality with apixaban in critically ill hospitalized COVID-19 patients. Our pilot study sought to determine the differences in all-cause mortality, venous thromboembolism (VTE), and bleeding events between apixaban and therapeutic heparin-based regimens in hospitalized non-critically ill COVID-19 patients. Methods: We conducted a retrospective analysis of non-critically ill COVID-19 patients aged ≥ 18 years admitted to 3 campuses of Montefiore Medical Center during the first (March 2020 to May 2020) and second (January 2021 to February 2021) COVID-19 surges, who received within 48 hours of admission and continued for ≥72 hours a therapeutic dose of low-molecular-weight heparin (LMWH), unfractionated heparin (UFH), or any apixaban dose for VTE prophylaxis. Outcomes data analyzed included mortality, suspected or imaging-confirmed VTE, and bleeding using a defined criteria. Results: Overall, 162 patients met eligibility for analysis. Baseline characteristics were similar between the 2 groups except liver and renal functions. Mortality occurred in 10 (13.3%) patients on apixaban and 23 (26.4%) patients on a heparin-based regimen (P =.059). Confirmed VTE events were not different between the groups (8% vs 13.8%, P =.359), but higher incidence of bleeding occurred in heparin-based group (4% vs 52.9%, P <.001). Conclusion: There were no differences in mortality or confirmed VTE between apixaban and heparin-based regimens except for more bleeding events with the heparins. This study highlights the utility of apixaban in COVID-19. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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