Effect of Anticoagulant Administration on the Mortality of Hospitalized Patients With COVID-19: An Updated Systematic Review and Meta-Analysis
Background: Anticoagulation is generally used in hospitalized patients with coronavirus disease 2019 (COVID-19) as thromboprophylaxis. However, results from different studies comparing the effect of anticoagulation on the mortality of COVID-19 patients with non-anticoagulation are inconclusive.Metho...
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doaj-b68cbf5f9879493994bc39e53acb0bcb2021-08-04T08:10:27ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2021-08-01810.3389/fmed.2021.698935698935Effect of Anticoagulant Administration on the Mortality of Hospitalized Patients With COVID-19: An Updated Systematic Review and Meta-AnalysisLuojia Jiang0Luojia Jiang1Yupei Li2Yupei Li3Heyue Du4Zheng Qin5Baihai Su6Baihai Su7Baihai Su8Baihai Su9Department of Nephrology, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Nephrology, Jiujiang No. 1 People's Hospital, Jiujiang, ChinaDepartment of Nephrology, West China Hospital, Sichuan University, Chengdu, ChinaDisaster Medicine Center, Institute for Disaster Management and Reconstruction, Sichuan University, Chengdu, ChinaDepartment of Nephrology, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Nephrology, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Nephrology, West China Hospital, Sichuan University, Chengdu, ChinaDisaster Medicine Center, Institute for Disaster Management and Reconstruction, Sichuan University, Chengdu, ChinaThe First People's Hospital of Shuangliu District, Chengdu, ChinaMed-X Center for Materials, Sichuan University, Chengdu, ChinaBackground: Anticoagulation is generally used in hospitalized patients with coronavirus disease 2019 (COVID-19) as thromboprophylaxis. However, results from different studies comparing the effect of anticoagulation on the mortality of COVID-19 patients with non-anticoagulation are inconclusive.Methods: Our systematic review included observational trials if they studied anticoagulant therapy in hospitalized patients with COVID-19 for mortality or bleeding events. Dichotomous variables from individual studies were pooled by risk ratio (RR) and their 95% confidence interval (95% CI) using the random-effects model. Grading of Recommendations Assessment, Development and Evaluation was used to assess the quality of evidence.Results: A total of 11 observational studies enrolling 20,748 hospitalized COVID-19 patients overall were included. A pooled meta-analysis of these studies showed that anticoagulation therapy, compared with non-anticoagulation therapy, was associated with lower mortality risk (RR 0.70, 95% CI 0.52–0.93, p = 0.01). The evidence of benefit was stronger among critically ill COVID-19 patients in the intensive care units (RR 0.59, 95% CI 0.43–0.83, p = 0.002). Additionally, severe bleeding events were not associated with the administration of anticoagulants (RR 0.93, 95% CI 0.71–1.23, p = 0.63).Conclusion: Among patients with COVID-19 admitted to hospital, the administration of anticoagulants was associated with a decreased mortality without increasing the incidence of bleeding events.https://www.frontiersin.org/articles/10.3389/fmed.2021.698935/fullanticoagulationcoronavirus disease 2019heparinmortalitybleeding |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Luojia Jiang Luojia Jiang Yupei Li Yupei Li Heyue Du Zheng Qin Baihai Su Baihai Su Baihai Su Baihai Su |
spellingShingle |
Luojia Jiang Luojia Jiang Yupei Li Yupei Li Heyue Du Zheng Qin Baihai Su Baihai Su Baihai Su Baihai Su Effect of Anticoagulant Administration on the Mortality of Hospitalized Patients With COVID-19: An Updated Systematic Review and Meta-Analysis Frontiers in Medicine anticoagulation coronavirus disease 2019 heparin mortality bleeding |
author_facet |
Luojia Jiang Luojia Jiang Yupei Li Yupei Li Heyue Du Zheng Qin Baihai Su Baihai Su Baihai Su Baihai Su |
author_sort |
Luojia Jiang |
title |
Effect of Anticoagulant Administration on the Mortality of Hospitalized Patients With COVID-19: An Updated Systematic Review and Meta-Analysis |
title_short |
Effect of Anticoagulant Administration on the Mortality of Hospitalized Patients With COVID-19: An Updated Systematic Review and Meta-Analysis |
title_full |
Effect of Anticoagulant Administration on the Mortality of Hospitalized Patients With COVID-19: An Updated Systematic Review and Meta-Analysis |
title_fullStr |
Effect of Anticoagulant Administration on the Mortality of Hospitalized Patients With COVID-19: An Updated Systematic Review and Meta-Analysis |
title_full_unstemmed |
Effect of Anticoagulant Administration on the Mortality of Hospitalized Patients With COVID-19: An Updated Systematic Review and Meta-Analysis |
title_sort |
effect of anticoagulant administration on the mortality of hospitalized patients with covid-19: an updated systematic review and meta-analysis |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Medicine |
issn |
2296-858X |
publishDate |
2021-08-01 |
description |
Background: Anticoagulation is generally used in hospitalized patients with coronavirus disease 2019 (COVID-19) as thromboprophylaxis. However, results from different studies comparing the effect of anticoagulation on the mortality of COVID-19 patients with non-anticoagulation are inconclusive.Methods: Our systematic review included observational trials if they studied anticoagulant therapy in hospitalized patients with COVID-19 for mortality or bleeding events. Dichotomous variables from individual studies were pooled by risk ratio (RR) and their 95% confidence interval (95% CI) using the random-effects model. Grading of Recommendations Assessment, Development and Evaluation was used to assess the quality of evidence.Results: A total of 11 observational studies enrolling 20,748 hospitalized COVID-19 patients overall were included. A pooled meta-analysis of these studies showed that anticoagulation therapy, compared with non-anticoagulation therapy, was associated with lower mortality risk (RR 0.70, 95% CI 0.52–0.93, p = 0.01). The evidence of benefit was stronger among critically ill COVID-19 patients in the intensive care units (RR 0.59, 95% CI 0.43–0.83, p = 0.002). Additionally, severe bleeding events were not associated with the administration of anticoagulants (RR 0.93, 95% CI 0.71–1.23, p = 0.63).Conclusion: Among patients with COVID-19 admitted to hospital, the administration of anticoagulants was associated with a decreased mortality without increasing the incidence of bleeding events. |
topic |
anticoagulation coronavirus disease 2019 heparin mortality bleeding |
url |
https://www.frontiersin.org/articles/10.3389/fmed.2021.698935/full |
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