Key result
Regular use of vitamin K antagonists prior to COVID-19 was associated with increased 7-day mortality in hospitalized frail older adults (HR 5.68; 95% CI 1.17-27.53).
Why the study?
Vitamin K concentrations are inversely associated with COVID-19 severity, prompting evaluation of whether prior regular vitamin K antagonist use is associated with short-term mortality in hospitalized frail older adults.
Does regular use of vitamin K antagonist prior to COVID-19 increase 7-day mortality in hospitalized frail elderly COVID-19 patients?
Cohort (n=82)
Does regular use of vitamin K antagonist prior to COVID-19 increase 7-day mortality in hospitalized frail elderly COVID-19 patients?
Hazard Ratio: 5.68 (95% CI 1.17–27.53)
p-value: p=0.031
Regular use of VKA prior to COVID-19 infection is associated with a significantly increased risk of short-term mortality in frail elderly patients hospitalized for COVID-19.
Background. Vitamin K concentrations are inversely associated with the clinical severity of COVID-19. The objective of this cohort study was to determine whether the regular use of vitamin K antagonist (VKA) prior to COVID-19 was associated with short-term mortality in frail older adults hospitalized for COVID-19. Methods. Eighty-two patients consecutively hospitalized for COVID-19 in a geriatric acute care unit were included. The association of the regular use of VKA prior to COVID-19 with survival after 7 days of COVID-19 was examined using a propensity-score-weighted Cox proportional-hazards model accounting for age, sex, severe undernutrition, diabetes mellitus, hypertension, prior myocardial infarction, congestive heart failure, prior stroke and/or transient ischemic attack, CHA2DS2-VASc score, HAS-BLED score, and eGFR. Results. Among 82 patients (mean ± SD age 88.8 ± 4.5 years; 48% women), 73 survived COVID-19 at day 7 while 9 died. There was no between-group difference at baseline, despite a trend for more frequent use of VKA in those who did not survive on day 7 (33.3% versus 8.2%, p = 0.056). While considering “using no VKA” as the reference (hazard ratio (HR) = 1), the HR for 7-day mortality in those regularly using VKA was 5.68 [95% CI: 1.17; 27.53]. Consistently, COVID-19 patients using VKA on a regular basis had shorter survival times than the others (p = 0.031). Conclusions. Regular use of VKA was associated with increased mortality at day 7 in hospitalized frail elderly patients with COVID-19.
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Ménager et al. (2020) conducted a cohort in COVID-19 (n=82). Regular use of vitamin K antagonist (VKA) prior to COVID-19 vs. No VKA use was evaluated on 7-day mortality (HR 5.68, 95% CI 1.17-27.53, p=0.031). Regular use of vitamin K antagonists prior to COVID-19 was associated with increased 7-day mortality in hospitalized frail older adults (HR 5.68; 95% CI 1.17-27.53).
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