Author: Kamel, Ahmed M.; Sobhy, Mona; Magdy, Nada; Sabry, Nirmeen; Farid, Samar
Title: Anticoagulation outcomes in hospitalized Covidâ€19 patients: A systematic review and metaâ€analysis of caseâ€control and cohort studies Cord-id: l9xmj8vi Document date: 2020_10_6
ID: l9xmj8vi
Snippet: Background: Coagulopathy and thromboembolic events are common in Covidâ€19 patients and are poor prognostic factors. Controversy exists regarding the potential of anticoagulation (AC) to reduce mortality and incidence of thromboembolic events in Covidâ€19 patients. The current systematic review and metaâ€analysis investigated the association between anticoagulants and mortality in adult hospitalized COVIDâ€19 patients using the available published nonâ€randomized studies. Methods: Google Sc
Document: Background: Coagulopathy and thromboembolic events are common in Covidâ€19 patients and are poor prognostic factors. Controversy exists regarding the potential of anticoagulation (AC) to reduce mortality and incidence of thromboembolic events in Covidâ€19 patients. The current systematic review and metaâ€analysis investigated the association between anticoagulants and mortality in adult hospitalized COVIDâ€19 patients using the available published nonâ€randomized studies. Methods: Google Scholar, PubMed, Scopus, the Cochrane Library and Clinical Trials.gov were searched for relevant studies. A metaâ€analysis of adjusted and unadjusted estimates was performed. The relative risk was used as a measure of effect. The randomâ€effects model was used to pool estimates using the generic inverse variance method. Results: Sixteen studies were included in the quantitative data synthesis. Results showed a statistically significant association between AC and mortality (RR = 0.56, 95% CI 0.36; 0.92, p = 0.02). Both therapeutic (Relative risk [RR] = 0.4, 95% CI 0.27; 0.57) and prophylactic AC (RR = 0.54, 95% CI 0.41; 0.71) were associated with lower risk of mortality. Preâ€admission AC was not associated with mortality (RR = 0.84, 95% CI 0.49; 1.43, p > 0.05) while prophylactic AC was associated with higher risk of mortality compared to therapeutic AC (RR = 1.58, 95% CI 1.34; 1.87, p < 0.001). Conclusion: Findings support the association of AC with mortality in Covidâ€19 patients. The results, synthesized from mostly lowâ€quality studies, show that prophylactic and therapeutic AC might reduce mortality in Covidâ€19 patients. Findings suggest that therapeutic doses might be associated with better survival compared to prophylactic doses.
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