Intermediate‐dose anticoagulation, aspirin, and in‐hospital mortality in COVID ‐19: A propensity score‐matched analysis
Matthew L Meizlish, George Goshua, Yiwen Liu, Rebecca Fine, Kejal Amin, Eric Chang, Nicholas Defilippo, Craig Keating, Yuxin Liu, Michael Mankbadi, Dayna Mcmanus, Stephen Y Wang, Christina Price, Robert D Bona, Cassius Iyad Ochoa Chaar, Hyung J Chun, Alexander B Pine, Henry M Rinder, Jonathan M Siner, Donna S Neuberg, Kent A Owusu, Alfred Ian Lee
American Journal of Hematology, doi:10.1002/ajh.26102
Thrombotic complications occur at high rates in hospitalized patients with COVID-19, yet the impact of intensive antithrombotic therapy on mortality is uncertain. We examined in-hospital mortality with intermediate-compared to prophylactic-dose anticoagulation, and separately with in-hospital aspirin compared to no antiplatelet therapy, in a large, retrospective study of 2785 hospitalized adult COVID-19 patients. In this analysis, we established two separate, nested cohorts of patients (a) who received intermediate-or prophylactic-dose anticoagulation ("anticoagulation cohort", N = 1624), or (b) who were not on home antiplatelet therapy and received either in-hospital aspirin or no antiplatelet therapy ("aspirin cohort", N = 1956). To minimize bias and adjust for confounding factors, we incorporated propensity score matching and multivariable regression utilizing various markers of illness severity and other patient-specific covariates, yielding treatment groups with well-balanced
ETHICS APPROVAL STATEMENT This study was approved by the Yale Institutional Review Board (HIC 2000027792).
PATIENT CONSENT STATEMENT Patient consent was not mandated for this study. Permission to reproduce material from other sources: No material from other sources is included in this study.
CLINICAL TRIAL REGISTRATION This study was not a clinical trial.
SUPPORTING INFORMATION Additional supporting information may be found online in the Supporting Information section at the end of this article.
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