DUGi

Does chronic anticoagulation improve prognosis among patients with Covid-19?: a population-based retrospective cohort

http://dugi.udg.edu/item/http:@@@@hdl.handle.net@@10256@@21583

Background: Coronavirus disease 2019 (COVID-19) has emerged as a global pandemic, with a considerable morbidity and mortality rate. Despite the fact that almost 80% of the Catalan population is fully vaccinated, the pandemic persist and the health system is overwhelmed. Therapeutic measures to reduce morbidity and mortality are therefore necessary. Although the main disease expression is in the respiratory tract, there is high evidence that the pathophysiological component of severe COVID-19 may be triggered by a procoagulant state. The coagulation system not only has an important role in macrothrombotic complications, it also contributes to the development of acute respiratory distress syndrome (ARDS). Despite multiple clinical trials performed, there is still no clear consensus on the optimal anticoagulation dose for the treatment of hospitalised patients. Thus, until new evidence emerges, the study of retrospective data on patients infected by SARS-CoV-2 receiving baseline chronic anticoagulation therapy and how this influences their prognosis, could provide new evidence on the importance of such treatment. Objective: The purpose of this study is to assess whether receiving chronic oral anticoagulation prior to COVID-19 infection is associated with an improved prognosis (reducing hospital admission, need for ventilatory support and mortality). Design: This study is a population-based retrospective cohort using linked health administration databases in Catalonia, Spain from 1 October 2020 to 31 December 2020. Participants and Methods: In this population-based study, we will review all patients aged 65 years or older with a laboratory-confirmed SARS-CoV-2 diagnose between 1 October 2020 to 31 December 2020 in Catalonia. Our sample will be divided into those who were receiving chronic anticoagulation for atrial fibrillation (exposed cohort) with those who were not (non- exposed cohort). After Propensity Score Matching (PSM) we will compare the outcomes (hospital admission, need for ventilatory support and mortality) between both cohorts