COVID-19 诊断前使用抗凝剂能否预防与 COVID-19 相关的急性静脉血栓栓塞:系统回顾和荟萃分析。

Kinza Iqbal, Akshat Banga, Taha Bin Arif, Sawai Singh Rathore, Abhishek Bhurwal, Syeda Kisa Batool Naqvi, Muhammad Mehdi, Pankaj Kumar, Mitali Madhu Salklan, Ayman Iqbal, Jawad Ahmed, Nikhil Sharma, Amos Lal, Rahul Kashyap, Vikas Bansal, Juan Pablo Domecq
{"title":"COVID-19 诊断前使用抗凝剂能否预防与 COVID-19 相关的急性静脉血栓栓塞:系统回顾和荟萃分析。","authors":"Kinza Iqbal, Akshat Banga, Taha Bin Arif, Sawai Singh Rathore, Abhishek Bhurwal, Syeda Kisa Batool Naqvi, Muhammad Mehdi, Pankaj Kumar, Mitali Madhu Salklan, Ayman Iqbal, Jawad Ahmed, Nikhil Sharma, Amos Lal, Rahul Kashyap, Vikas Bansal, Juan Pablo Domecq","doi":"10.5662/wjm.v14.i3.92983","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Coagulopathy and thromboembolic events are associated with poor outcomes in coronavirus disease 2019 (COVID-19) patients. There is conflicting evidence on the effects of chronic anticoagulation on mortality and severity of COVID-19 disease.</p><p><strong>Aim: </strong>To summarize the body of evidence on the effects of pre-hospital anticoagulation on outcomes in COVID-19 patients.</p><p><strong>Methods: </strong>A Literature search was performed on LitCovid PubMed, WHO, and Scopus databases from inception (December 2019) till June 2023 for original studies reporting an association between prior use of anticoagulants and patient outcomes in adults with COVID-19. The primary outcome was the risk of thromboembolic events in COVID-19 patients taking anticoagulants. Secondary outcomes included COVID-19 disease severity, in terms of intensive care unit admission or invasive mechanical ventilation/intubation requirement in patients hospitalized with COVID-19 infection, and mortality. The random effects models were used to calculate crude and adjusted odds ratios (aORs) with 95% confidence intervals (95%CIs).</p><p><strong>Results: </strong>Forty-six observational studies met our inclusion criteria. The unadjusted analysis found no association between prior anticoagulation and thromboembolic event risk [<i>n</i> = 43851, 9 studies, odds ratio (OR)= 0.67 (0.22, 2.07); <i>P</i> = 0.49; <i>I</i> <sup>2</sup> = 95%]. The association between prior anticoagulation and disease severity was non-significant [<i>n</i> = 186782; 22 studies, OR = 1.08 (0.78, 1.49); <i>P</i> = 0.64; <i>I</i> <sup>2</sup> = 89%]. However, pre-hospital anticoagulation significantly increased all-cause mortality risk [<i>n</i> = 207292; 35 studies, OR = 1.72 (1.37, 2.17); <i>P</i> < 0.00001; <i>I</i> <sup>2</sup> = 93%]. Pooling adjusted estimates revealed a statistically non-significant association between pre-hospital anticoagulation and thromboembolic event risk [aOR = 0.87 (0.42, 1.80); <i>P</i> = 0.71], mortality [aOR = 0.94 (0.84, 1.05); <i>P</i> = 0.31], and disease severity [aOR = 0.96 (0.72, 1.26); <i>P</i> = 0.76].</p><p><strong>Conclusion: </strong>Prehospital anticoagulation was not significantly associated with reduced risk of thromboembolic events, improved survival, and lower disease severity in COVID-19 patients.</p>","PeriodicalId":94271,"journal":{"name":"World journal of methodology","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11230074/pdf/","citationCount":"0","resultStr":"{\"title\":\"Anticoagulant use before COVID-19 diagnosis prevent COVID-19 associated acute venous thromboembolism or not: A systematic review and meta-analysis.\",\"authors\":\"Kinza Iqbal, Akshat Banga, Taha Bin Arif, Sawai Singh Rathore, Abhishek Bhurwal, Syeda Kisa Batool Naqvi, Muhammad Mehdi, Pankaj Kumar, Mitali Madhu Salklan, Ayman Iqbal, Jawad Ahmed, Nikhil Sharma, Amos Lal, Rahul Kashyap, Vikas Bansal, Juan Pablo Domecq\",\"doi\":\"10.5662/wjm.v14.i3.92983\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Coagulopathy and thromboembolic events are associated with poor outcomes in coronavirus disease 2019 (COVID-19) patients. There is conflicting evidence on the effects of chronic anticoagulation on mortality and severity of COVID-19 disease.</p><p><strong>Aim: </strong>To summarize the body of evidence on the effects of pre-hospital anticoagulation on outcomes in COVID-19 patients.</p><p><strong>Methods: </strong>A Literature search was performed on LitCovid PubMed, WHO, and Scopus databases from inception (December 2019) till June 2023 for original studies reporting an association between prior use of anticoagulants and patient outcomes in adults with COVID-19. The primary outcome was the risk of thromboembolic events in COVID-19 patients taking anticoagulants. Secondary outcomes included COVID-19 disease severity, in terms of intensive care unit admission or invasive mechanical ventilation/intubation requirement in patients hospitalized with COVID-19 infection, and mortality. The random effects models were used to calculate crude and adjusted odds ratios (aORs) with 95% confidence intervals (95%CIs).</p><p><strong>Results: </strong>Forty-six observational studies met our inclusion criteria. The unadjusted analysis found no association between prior anticoagulation and thromboembolic event risk [<i>n</i> = 43851, 9 studies, odds ratio (OR)= 0.67 (0.22, 2.07); <i>P</i> = 0.49; <i>I</i> <sup>2</sup> = 95%]. The association between prior anticoagulation and disease severity was non-significant [<i>n</i> = 186782; 22 studies, OR = 1.08 (0.78, 1.49); <i>P</i> = 0.64; <i>I</i> <sup>2</sup> = 89%]. However, pre-hospital anticoagulation significantly increased all-cause mortality risk [<i>n</i> = 207292; 35 studies, OR = 1.72 (1.37, 2.17); <i>P</i> < 0.00001; <i>I</i> <sup>2</sup> = 93%]. Pooling adjusted estimates revealed a statistically non-significant association between pre-hospital anticoagulation and thromboembolic event risk [aOR = 0.87 (0.42, 1.80); <i>P</i> = 0.71], mortality [aOR = 0.94 (0.84, 1.05); <i>P</i> = 0.31], and disease severity [aOR = 0.96 (0.72, 1.26); <i>P</i> = 0.76].</p><p><strong>Conclusion: </strong>Prehospital anticoagulation was not significantly associated with reduced risk of thromboembolic events, improved survival, and lower disease severity in COVID-19 patients.</p>\",\"PeriodicalId\":94271,\"journal\":{\"name\":\"World journal of methodology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-09-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11230074/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"World journal of methodology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.5662/wjm.v14.i3.92983\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"World journal of methodology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5662/wjm.v14.i3.92983","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

背景:凝血功能障碍和血栓栓塞事件与2019年冠状病毒病(COVID-19)患者的不良预后有关。关于慢性抗凝对死亡率和COVID-19疾病严重程度的影响,存在相互矛盾的证据。目的:总结院前抗凝对COVID-19患者预后影响的证据:方法:在LitCovid PubMed、WHO和Scopus数据库中进行文献检索,检索自开始(2019年12月)至2023年6月期间报告COVID-19成人患者之前使用抗凝剂与患者预后之间关系的原始研究。主要结果是服用抗凝药物的 COVID-19 患者发生血栓栓塞事件的风险。次要结果包括COVID-19疾病的严重程度(以COVID-19感染住院患者入住重症监护室或需要有创机械通气/插管的时间计算)和死亡率。随机效应模型用于计算粗略和调整后的几率比(aORs)及95%置信区间(95%CIs):46项观察性研究符合我们的纳入标准。未调整分析发现,既往抗凝与血栓栓塞事件风险之间没有关联[n = 43851,9 项研究,几率比(OR)= 0.67 (0.22, 2.07);P = 0.49;I 2 = 95%]。既往抗凝与疾病严重程度之间的关系不显著[n = 186782;22 项研究,OR = 1.08 (0.78, 1.49);P = 0.64;I 2 = 89%]。然而,院前抗凝会显著增加全因死亡风险[n = 207292;35 项研究,OR = 1.72 (1.37, 2.17);P < 0.00001;I 2 = 93%]。汇总调整后的估计值显示,院前抗凝与血栓栓塞事件风险[aOR = 0.87 (0.42, 1.80);P = 0.71]、死亡率[aOR = 0.94 (0.84, 1.05);P = 0.31]和疾病严重程度[aOR = 0.96 (0.72, 1.26);P = 0.76]之间的关系在统计学上并不显著:结论:COVID-19患者院前抗凝与血栓栓塞事件风险的降低、生存率的提高和疾病严重程度的降低并无明显关联。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Anticoagulant use before COVID-19 diagnosis prevent COVID-19 associated acute venous thromboembolism or not: A systematic review and meta-analysis.

Background: Coagulopathy and thromboembolic events are associated with poor outcomes in coronavirus disease 2019 (COVID-19) patients. There is conflicting evidence on the effects of chronic anticoagulation on mortality and severity of COVID-19 disease.

Aim: To summarize the body of evidence on the effects of pre-hospital anticoagulation on outcomes in COVID-19 patients.

Methods: A Literature search was performed on LitCovid PubMed, WHO, and Scopus databases from inception (December 2019) till June 2023 for original studies reporting an association between prior use of anticoagulants and patient outcomes in adults with COVID-19. The primary outcome was the risk of thromboembolic events in COVID-19 patients taking anticoagulants. Secondary outcomes included COVID-19 disease severity, in terms of intensive care unit admission or invasive mechanical ventilation/intubation requirement in patients hospitalized with COVID-19 infection, and mortality. The random effects models were used to calculate crude and adjusted odds ratios (aORs) with 95% confidence intervals (95%CIs).

Results: Forty-six observational studies met our inclusion criteria. The unadjusted analysis found no association between prior anticoagulation and thromboembolic event risk [n = 43851, 9 studies, odds ratio (OR)= 0.67 (0.22, 2.07); P = 0.49; I 2 = 95%]. The association between prior anticoagulation and disease severity was non-significant [n = 186782; 22 studies, OR = 1.08 (0.78, 1.49); P = 0.64; I 2 = 89%]. However, pre-hospital anticoagulation significantly increased all-cause mortality risk [n = 207292; 35 studies, OR = 1.72 (1.37, 2.17); P < 0.00001; I 2 = 93%]. Pooling adjusted estimates revealed a statistically non-significant association between pre-hospital anticoagulation and thromboembolic event risk [aOR = 0.87 (0.42, 1.80); P = 0.71], mortality [aOR = 0.94 (0.84, 1.05); P = 0.31], and disease severity [aOR = 0.96 (0.72, 1.26); P = 0.76].

Conclusion: Prehospital anticoagulation was not significantly associated with reduced risk of thromboembolic events, improved survival, and lower disease severity in COVID-19 patients.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信