Intermediate-dose anticoagulation, aspirin, and in-hospital mortality in COVID-19: A propensity score-matched analysis
Meizlish et al.,
Intermediate-dose anticoagulation, aspirin, and in-hospital mortality in COVID-19: A propensity score-matched..,
American Journal of Hematology, doi:10.1002/ajh.26102
Retrospective 638 matched hospitalized patients in the USA, 319 treated with aspirin, showing lower mortality with treatment.
risk of death, 47.8% lower, HR 0.52, p = 0.004, treatment 319, control 319, PSM.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Meizlish et al., 21 Jan 2021, retrospective, propensity score matching, USA, peer-reviewed, 22 authors.
Abstract: Received: 18 January 2021
Accepted: 18 January 2021
DOI: 10.1002/ajh.26102
RESEARCH ARTICLE
Intermediate-dose anticoagulation, aspirin, and in-hospital
mortality in COVID-19: A propensity score-matched analysis
Matthew L. Meizlish1
| George Goshua2
| Yiwen Liu3 | Rebecca Fine4 |
Kejal Amin5 | Eric Chang2 | Nicholas DeFilippo5,6 | Craig Keating7 | Yuxin Liu2 |
Michael Mankbadi4 | Dayna McManus5 | Stephen Y. Wang4 | Christina Price8
Robert D. Bona2 | Cassius Iyad Ochoa Chaar9 | Hyung J. Chun10 |
Alexander B. Pine2 | Henry M. Rinder2,11 | Jonathan M. Siner12
Donna S. Neuberg3 | Kent A. Owusu5,13 | Alfred Ian Lee2
1
Yale School of Medicine, New Haven, Connecticut, USA
2
Section of Hematology, Department of Medicine, Yale School of Medicine, New Haven, Connecticut, USA
3
Dana-Farber Cancer Institute, Boston, Massachusetts, USA
4
Department of Medicine, Yale School of Medicine, New Haven, Connecticut, USA
5
Department of Pharmacy, Yale-New Haven Hospital, New Haven, Connecticut, USA
6
School of Pharmacy, University of Connecticut, Storrs, Connecticut, USA
7
Joint Data Analytics Team, Yale New Haven Hospital, New Haven, Connecticut, USA
8
Section of Allergy and Immunology, Department of Medicine, Yale School of Medicine, New Haven, Connecticut, USA
9
Section of Vascular Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA
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10
Section of Cardiology, Department of Medicine, Yale School of Medicine, New Haven, Connecticut, USA
11
Department of Laboratory Medicine, Yale School of Medicine, New Haven, Connecticut, USA
12
Section of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Yale School of Medicine, New Haven, Connecticut, USA
13
Clinical Redesign, Yale New Haven Health, New Haven, Connecticut, USA
Correspondence
Alfred Ian Lee, Section of Hematology,
Department of Medicine, Yale School of
Medicine, New Haven, CT 06510.
Email: alfred.lee@yale.edu
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Abstract
Thrombotic complications occur at high rates in hospitalized patients with COVID19, yet the impact of intensive antithrombotic therapy on mortality is uncertain. We
examined in-hospital mortality with intermediate- compared to prophylactic-dose
Kent A. Owusu, Department of Pharmacy,
Yale-New Haven Hospital, New Haven, CT
06510.
Email: kent.owusu@ynhh.org
Donna S. Neuberg, Dana-Farber Cancer
Institute, Boston, MA 02115.
Email: neuberg@ds.dfci.harvard.edu
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
Funding information
National Institutes of Health, Grant/Award
Numbers: HL139116, GM136651, HL142818;
Hemostasis and Thrombosis Research Society;
American Society of Hematology
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
Matthew L. Meizlish, George Goshua, Yiwen Liu and Rebecca Fine contributed equally as first authors.
Donna S. Neuberg, Kent A. Owusu and..
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