Retrospective analysis finds no significant link between oral anticoagulant therapy and medium-term mortality in COVID-19 patients, highlighting the importance of comorbidities.
Background and Purpose of the study: People affected by COVID-19 have been exposed to abnormal clotting and endothelial dysfunction, which may result in thromboembolic events. The purpose of this study was to test whether the oral anticoagulant therapy OAT (both DOACs and VKAs) may impact on the medium-term mortality in a cohort of SARS-CoV2 patients.Materials and Methods: 1238 patients hospitalized for COVID-19 at our hospital from March 17, 2020, to June 15, 2021, were analyzed; 247 survivors and 247 deceased within 90 days from hospitalization were matched 1:1 based on age, sex and ICU admission within 3 days. Conditional logistic regression was used to estimate associations by means of Odds Ratio with 95% confidence interval.Results: The group of survivors was comparable to the group of deceased patients for age (76±10 years), gender (141 men and 106 women in each group) and hospitalization in ICU (25 per group). Compared to patients living at 90 days, those with a fatal event achieved more frequently heart failure, HF (10.5% vs. 23.1%; p <0.001), atrial fibrillation, AF (13.4% vs. 22.3%; p=0.009), as well as respiratory disease or COPD, and renal failure. Subjects in OAT were 60 (24.3%) in the group of survivors and 69 (27.9%) in the group of deceased patients.Conclusions: While HF and AF, characterized by a pro-thrombotic state that frequently complicate one another, are among the comorbidities mainly associated to medium-term mortality of COVID-19 patients, no statistically significant link was detected between the examined clinical parameters and OAT.
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