Direct oral anticoagulant use and risk of severe COVID-19Show others and affiliations
2021 (English)In: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 289, no 3, p. 411-419Article in journal (Refereed) Published
Abstract [en]
Background: Hypercoagulability and thromboembolism are prominent features of severe COVID-19, and ongoing anticoagulant use might be protective.
Methods: We conducted a nationwide register-based cohort study in Sweden, February through May, 2020, to assess whether ongoing direct oral anticoagulant (DOAC) use was associated with reduced risk of hospital admission for laboratory-confirmed COVID-19, or a composite of intensive care unit (ICU) admission or death due to laboratory-confirmed COVID-19.
Results: DOAC use (n = 103 703) was not associated with reduced risk of hospital admission for COVID-19 (adjusted hazard ratio [aHR] [95% confidence interval] 1.00 [0.75-1.33] vs. nonuse atrial fibrillation comparator [n = 36 875]; and aHR 0.94 [0.80-1.10] vs. nonuse cardiovascular disease comparator [n = 355 699]), or ICU admission or death due to COVID-19 (aHRs 0.76 [0.51-1.12], and 0.90 [0.71-1.15], respectively). '
Conclusion: Ongoing DOAC use was not associated with reduced risk of severe COVID-19, indicating that prognosis would not be modified by early outpatient DOAC initiation.
Place, publisher, year, edition, pages
John Wiley & Sons, 2021. Vol. 289, no 3, p. 411-419
Keywords [en]
anticoagulants, atrial fibrillation, COVID‐, 19, direct‐, acting oral anticoagulants, SARS‐, CoV‐, 2
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:oru:diva-88299DOI: 10.1111/joim.13205ISI: 000600032600001PubMedID: 33258156Scopus ID: 2-s2.0-85097746345OAI: oai:DiVA.org:oru-88299DiVA, id: diva2:1519649
Funder
Swedish Research Council
Note
Funding Agencies:
Swedish Government Funds for Clinical Research (ALF)
Karolinska Institutet Strategic Research Area Epidemiology programme
2021-01-192021-01-192021-03-25Bibliographically approved