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The Association of Low Molecular Weight Heparin Use and In-hospital Mortality Among Patients Hospitalized with COVID-19
- Source :
- Cardiovascular Drugs and Therapy
- Publication Year :
- 2021
- Publisher :
- Springer Science and Business Media LLC, 2021.
-
Abstract
- Purpose To determine the association between low molecular weight heparin (LMWH) use and mortality in hospitalized COVID-19 patients. Methods We conducted a retrospective study of patients consecutively enrolled from two major academic hospitals exclusively for COVID-19 in Wuhan, China, from January 26, 2020, to March 26, 2020. The primary outcome was adjusted in-hospital mortality in the LMWH group compared with the non-LMWH group using the propensity score. Results Overall, 525 patients with COVID-19 enrolled with a median age of 64 years (IQR 19), and 49.33% men. Among these, 120 (22.86%) were treated with LMWH. Compared with the non-LMWH group, the LMWH group was more likely to be older and male; had a history of hypertension, diabetes, coronary heart disease (CHD), or stroke; and had more severe COVID-19 parameters such as higher inflammatory cytokines or D-dimer. Compared with non-LMWH group, LMWH group had a higher unadjusted in-hospital mortality rate (21.70% vs. 11.10%; p = 0.004), but a lower adjusted mortality risk (adjusted odds ratio [OR], 0.20; 95% CI, 0.09–0.46). A propensity score-weighting analysis demonstrated similar findings (adjusted OR, 0.18; 95% CI, 0.10–0.30). Subgroup analysis showed a significant survival benefit among those who were severely (adjusted OR, 0.07; 95% CI, 0.02–0.23) and critically ill (adjusted OR, 0.32; 95% CI, 0.15–0.65), as well as among the elderly patients’ age > 65, IL-6 > 10 times upper limit level, and D-dimer > 5 times upper limit level. Conclusions Among hospitalized COVID-19 patients, LMWH use was associated with lower all-cause in-hospital mortality than non-LMWH users. The survival benefit was particularly significant among more severely ill patients.
- Subjects :
- Male
China
medicine.medical_specialty
Time Factors
medicine.drug_class
Low molecular weight heparin
Hemorrhage
Subgroup analysis
Comorbidity
Risk Assessment
Severity of Illness Index
Risk Factors
Internal medicine
Diabetes mellitus
medicine
Humans
Pharmacology (medical)
Hospital Mortality
Blood Coagulation
Stroke
Aged
Retrospective Studies
Aged, 80 and over
Pharmacology
business.industry
Mortality rate
Anticoagulants
COVID-19
Retrospective cohort study
General Medicine
Odds ratio
Heparin, Low-Molecular-Weight
Middle Aged
medicine.disease
LMWH
COVID-19 Drug Treatment
Hospitalization
In-hospital mortality
Treatment Outcome
Propensity score matching
Female
Original Article
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 15737241 and 09203206
- Volume :
- 36
- Database :
- OpenAIRE
- Journal :
- Cardiovascular Drugs and Therapy
- Accession number :
- edsair.doi.dedup.....8a4ff308ee86bdc6ee05dd0377f5602f