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Prophylactic Anticoagulation May Cut COVID-19 Mortality

FRIDAY, Feb. 12, 2021 -- Prophylactic anticoagulation is associated with reduced risk of 30-day mortality among patients admitted to hospital with severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection, according to a study published online Feb. 11 in The BMJ.

Christopher T. Rentsch, Ph.D., from the London School of Hygiene & Tropical Medicine, and colleagues conducted an observational study involving 4,297 patients admitted to hospital with laboratory-confirmed SARS-CoV-2 infection with no history of anticoagulation.

Of the patients, 84.4 percent received prophylactic anticoagulation within 24 hours of admission; more than 99 percent of treated patients received subcutaneous heparin or enoxaparin. The researchers identified 622 deaths within 30 days of hospital admission: 513 among those who received prophylactic anticoagulation. Eighty-two percent of the deaths occurred during hospital stay. The cumulative incidence of 30-day mortality was 14.3 and 18.7 percent, respectively, among those who received and did not receive prophylactic anticoagulation. The risk of 30-day mortality was significantly reduced for patients who did versus those who did not receive prophylactic anticoagulation (hazard ratio, 0.73; 95 percent confidence interval, 0.66 to 0.81). Similar associations were observed for inpatient mortality and initiation of therapeutic anticoagulation. No significant association was seen for receipt of prophylactic anticoagulation with increased risk of bleeding that required transfusion (hazard ratio, 0.87; 95 percent confidence interval, 0.71 to 1.05).

"Our results provide strong real world evidence to support guidelines recommending the use of prophylactic anticoagulation as initial treatment for patients with COVID-19 on hospital admission," the authors write

Several authors disclosed financial ties to the pharmaceutical industry.

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