{"title":"新冠肺炎患者长期抗凝治疗的当代结果：全国住院患者样本的回归匹配敏感性分析。","authors":"Amro Taha, Irisha Badu, Harigopal Sandhyavenu, Varun Victor, Sanchit Duhan, Lalitsiri Atti, Hasham Masood Qureshi, Thatiana Schulze Goni, Bijeta Keisham, Vasantha Sandhya Venu, Harshith Thyagaturu, Karthik Gonuguntla, Waqas Ullah, Himanshu Deshwal, Sudarshan Balla","doi":"10.1080/14779072.2023.2234282","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The role of oral anticoagulation during the COVID-19 pandemic has been debated widely. We studied the clinical outcomes of COVID-19 hospitalizations in patients who were on long-term anticoagulation.</p><p><strong>Research design and methods: </strong>The Nationwide Inpatient Sample (NIS) database from 2020 was queried to identify COVID-19 patients with and without long-term anticoagulation. Multivariate regression analysis was used to calculate the adjusted odds ratio (aOR) of in-hospital outcomes.</p><p><strong>Results: </strong>Of 1,060,925 primary COVID-19 hospitalizations, 102,560 (9.6%) were on long-term anticoagulation. On adjusted analysis, COVID-19 patients on anticoagulation had significantly lower odds of in-hospital mortality (aOR 0.61, 95% CI 0.58-0.64, <i>P</i> < 0.001), acute myocardial infarction (aOR 0.72, 95% CI 0.63-0.83, <i>P</i> < 0.001), stroke (aOR 0.79, 95% CI 0.66-0.95, <i>P</i> < 0.013), ICU admissions, (aOR 0.53, 95% CI 0.49-0.57, <i>P</i> < 0.001) and higher odds of acute pulmonary embolism (aOR 1.47, 95% CI 1.34-1.61, <i>P</i> < 0.001), acute deep vein thrombosis (aOR 1.17, 95% CI 1.05-1.31, <i>P</i> = 0.005) compared to COVID-19 patients who were not on anticoagulation.</p><p><strong>Conclusions: </strong>Compared to COVID-19 patients not on long-term anticoagulation, we observed lower in-hospital mortality, stroke and acute myocardial infarction in COVID-19 patients on long-term anticoagulation. Prospective studies are needed for optimal anticoagulation strategies in hospitalized patients.</p>","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":"21 8","pages":"601-608"},"PeriodicalIF":1.8000,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Contemporary outcomes of long-term anticoagulation in COVID-19 patients: a regression matched sensitivity analysis of the national inpatient sample.\",\"authors\":\"Amro Taha, Irisha Badu, Harigopal Sandhyavenu, Varun Victor, Sanchit Duhan, Lalitsiri Atti, Hasham Masood Qureshi, Thatiana Schulze Goni, Bijeta Keisham, Vasantha Sandhya Venu, Harshith Thyagaturu, Karthik Gonuguntla, Waqas Ullah, Himanshu Deshwal, Sudarshan Balla\",\"doi\":\"10.1080/14779072.2023.2234282\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The role of oral anticoagulation during the COVID-19 pandemic has been debated widely. We studied the clinical outcomes of COVID-19 hospitalizations in patients who were on long-term anticoagulation.</p><p><strong>Research design and methods: </strong>The Nationwide Inpatient Sample (NIS) database from 2020 was queried to identify COVID-19 patients with and without long-term anticoagulation. Multivariate regression analysis was used to calculate the adjusted odds ratio (aOR) of in-hospital outcomes.</p><p><strong>Results: </strong>Of 1,060,925 primary COVID-19 hospitalizations, 102,560 (9.6%) were on long-term anticoagulation. On adjusted analysis, COVID-19 patients on anticoagulation had significantly lower odds of in-hospital mortality (aOR 0.61, 95% CI 0.58-0.64, <i>P</i> < 0.001), acute myocardial infarction (aOR 0.72, 95% CI 0.63-0.83, <i>P</i> < 0.001), stroke (aOR 0.79, 95% CI 0.66-0.95, <i>P</i> < 0.013), ICU admissions, (aOR 0.53, 95% CI 0.49-0.57, <i>P</i> < 0.001) and higher odds of acute pulmonary embolism (aOR 1.47, 95% CI 1.34-1.61, <i>P</i> < 0.001), acute deep vein thrombosis (aOR 1.17, 95% CI 1.05-1.31, <i>P</i> = 0.005) compared to COVID-19 patients who were not on anticoagulation.</p><p><strong>Conclusions: </strong>Compared to COVID-19 patients not on long-term anticoagulation, we observed lower in-hospital mortality, stroke and acute myocardial infarction in COVID-19 patients on long-term anticoagulation. Prospective studies are needed for optimal anticoagulation strategies in hospitalized patients.</p>\",\"PeriodicalId\":12098,\"journal\":{\"name\":\"Expert Review of Cardiovascular Therapy\",\"volume\":\"21 8\",\"pages\":\"601-608\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2023-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Expert Review of Cardiovascular Therapy\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1080/14779072.2023.2234282\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/7/10 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Expert Review of Cardiovascular Therapy","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1080/14779072.2023.2234282","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/7/10 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
摘要
背景：口服抗凝在新冠肺炎大流行期间的作用一直备受争议。我们研究了长期接受抗凝治疗的新冠肺炎患者住院的临床结果。研究设计和方法：查询2020年全国住院患者样本（NIS）数据库，以确定新冠肺炎长期抗凝和非抗凝患者。多变量回归分析用于计算住院结果的调整比值比（aOR）。结果：在1060925例原发性新冠肺炎住院患者中，102560例（9.6%）接受了长期抗凝治疗。经调整的分析显示，接受抗凝治疗的新冠肺炎患者住院死亡率的几率显著降低（aOR 0.61，95%CI 0.58-0.64，P P P P P P = 0.005）与未接受抗凝治疗的新冠肺炎患者相比。结论：与未长期抗凝的新冠肺炎患者相比，长期抗凝的新冠肺炎患者住院死亡率、卒中和急性心肌梗死较低。需要对住院患者的最佳抗凝策略进行前瞻性研究。
Contemporary outcomes of long-term anticoagulation in COVID-19 patients: a regression matched sensitivity analysis of the national inpatient sample.
Background: The role of oral anticoagulation during the COVID-19 pandemic has been debated widely. We studied the clinical outcomes of COVID-19 hospitalizations in patients who were on long-term anticoagulation.
Research design and methods: The Nationwide Inpatient Sample (NIS) database from 2020 was queried to identify COVID-19 patients with and without long-term anticoagulation. Multivariate regression analysis was used to calculate the adjusted odds ratio (aOR) of in-hospital outcomes.
Results: Of 1,060,925 primary COVID-19 hospitalizations, 102,560 (9.6%) were on long-term anticoagulation. On adjusted analysis, COVID-19 patients on anticoagulation had significantly lower odds of in-hospital mortality (aOR 0.61, 95% CI 0.58-0.64, P < 0.001), acute myocardial infarction (aOR 0.72, 95% CI 0.63-0.83, P < 0.001), stroke (aOR 0.79, 95% CI 0.66-0.95, P < 0.013), ICU admissions, (aOR 0.53, 95% CI 0.49-0.57, P < 0.001) and higher odds of acute pulmonary embolism (aOR 1.47, 95% CI 1.34-1.61, P < 0.001), acute deep vein thrombosis (aOR 1.17, 95% CI 1.05-1.31, P = 0.005) compared to COVID-19 patients who were not on anticoagulation.
Conclusions: Compared to COVID-19 patients not on long-term anticoagulation, we observed lower in-hospital mortality, stroke and acute myocardial infarction in COVID-19 patients on long-term anticoagulation. Prospective studies are needed for optimal anticoagulation strategies in hospitalized patients.
期刊介绍：
Expert Review of Cardiovascular Therapy (ISSN 1477-9072) provides expert reviews on the clinical applications of new medicines, therapeutic agents and diagnostics in cardiovascular disease. Coverage includes drug therapy, heart disease, vascular disorders, hypertension, cholesterol in cardiovascular disease, heart disease, stroke, heart failure and cardiovascular surgery. The Expert Review format is unique. Each review provides a complete overview of current thinking in a key area of research or clinical practice.
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