Observational study of patients receiving
systemic anticoagulation (AC).
"Among 2,773 hospitalized COVID-19 patients, 786 (28%) received systemic AC during
their hospital course. The median (IQR) hospitalization duration was 5 days (3-8 days). Median
(IQR) time from admission to AC initiation was 2 days (0-5 days). Median (IQR) duration of AC
treatment was 3 days (2-7 days).
In-hospital mortality for patients treated with AC was 22.5%
with a median survival of 21 days, compared to 22.8% and median survival of 14 days in
patients who did not receive AC (Figure 1A). Patients who received AC were more likely to
require invasive mechanical ventilation (29.8% vs 8.1%, p<0.001). Overall, we observed
significantly increased baseline prothrombin time, activated partial thromboplastin time, lactate dehydrogenase, ferritin, C reactive protein, and D-dimer values among individuals who received
in-hospital AC as compared to those who did not. These differences were not observed, however,
among mechanically ventilated patients.
In patients who required mechanical ventilation
(N=395), in-hospital mortality was 29.1% with a median survival of 21 days for those treated
with AC as compared to 62.7% with a median survival of 9 days in patients who did not receive
AC (Figure 1B).
In a multivariate proportional hazards model, longer duration of AC treatment
was associated with a reduced risk of mortality (adjusted HR of 0.86 per day, 95% confidence
interval 0.82-0.89, p<0.001)."
https://www.onlinejacc.org/content/early/2020/05/05/j.jacc.2020.05.001?_ga=2.25452607.368525428.159006 6962-1524494810.1590066962&fbclid=IwAR38sgFLfONiXc9XWTkhW-b7oJSH7G2kVTCN3JtPeDX5ARLd1jnJqRWBe7w
This suggests to me that anti-coagulants have a modest benefit. Selection bias effect unclear.