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The association between anticoagulation and adverse outcomes after a positive SARS-CoV-2 test among older outpatients: A population-based cohort study.
- Source :
-
Thrombosis Research . Mar2022, Vol. 211, p114-122. 9p. - Publication Year :
- 2022
-
Abstract
- Anticoagulation may improve outcomes in patients with COVID-19 when started early in the course of illness. This was a population-based cohort study using linked administrative datasets of outpatients aged ≥65 years old testing positive for SARS-CoV-2 between January 1 and December 31, 2020 in Ontario, Canada. The key exposure was anticoagulation with warfarin or direct oral anticoagulants before COVID-19 diagnosis. We calculated propensity scores and used matching weights (MWs) to reduce baseline differences between anticoagulated and non-anticoagulated patients. The primary outcome was a composite of death or hospitalization within 60 days of a positive SARS-CoV-2 test. We used the Kaplan-Meier method and cumulative incidence functions to estimate risk of the primary and component outcomes at 60 days. We studied 23,159 outpatients (mean age 78.5 years; 13,474 [58.2%] female), among whom 3200 (13.8%) deaths and 3183 (13.7%) hospitalizations occurred within 60 days of the SARS-CoV-2 test. After application of MWs, the 60-day risk of death or hospitalization was 29.2% (95% CI 27.4%–31.2%) for anticoagulated individuals and 32.1% (95% CI 30.7%–33.5%) without anticoagulation (absolute risk difference [ARD], −2.9%; p = 0.005). Anticoagulation was also associated with a lower risk of death: 18.6% (95% CI 17.0%–20.2%) with anticoagulation and 20.9% (95% CI 19.7%–22.2%) in non-anticoagulated patients (ARD -2.3%; p = 0.005). Among outpatients aged ≥65 years, oral anticoagulation at the time of a positive SARS-CoV-2 test was associated with a lower risk of a composite of death or hospitalization within 60 days. • This was a population-based cohort study of older patients diagnosed with COVID-19. • Anticoagulation at time of COVID-19 diagnosis was associated with improved outcomes. • Early anticoagulation in high-risk outpatients merits study in a randomized controlled trial. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 00493848
- Volume :
- 211
- Database :
- Academic Search Index
- Journal :
- Thrombosis Research
- Publication Type :
- Academic Journal
- Accession number :
- 155461060
- Full Text :
- https://doi.org/10.1016/j.thromres.2021.12.010