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Management with antithrombotic agents is substantially linked with a decline in mortality rates, particularly, in people older than fifty-nine years.
In an observational, retrospective, multicentre study (START-COVID-19 Register), antithrombotic drugs therapy resulted in a 60% decrease in mortality rates in hospitalized COVID-19 patients. SARS-CoV-2 infection may predispose to thromboembolic disease. Thus, investigators aimed to elucidate the clinical characteristics of 1091 coronavirus-infected people admitted to ordinary wards, and examine the bleeding and thrombotic events occurring during hospitalization.
Also, the approaches utilized for thromboprophylaxis and its impact on patient outcomes were elucidated. During hospitalization, 769 (70.7%) people were managed with antithrombotics: fondaparinux, low molecular weight heparin (majority with enoxaparin), or unfractionated heparin. These people were more commonly influenced by other comorbidities like atrial fibrillation, cancer, previous thromboembolism, neurological disease, and hypertension in comparison with people who were not given thromboprophylaxis.
Compared to people who were not given thromboprophylaxis, people receiving thromboprophylaxis were more commonly influenced by comorbidities like neurological disease, hypertension, cancer, atrial fibrillation, and previous thromboembolism. During hospitalization, 1.2% of people witnessed a major bleeding event. Notably, all the people were managed with antithrombotic agents. Overall, 5.4% had venous thromboembolism [66.1% people had pulmonary embolism, 30.5% people had deep vein thrombosis, and 3.4% people had pulmonary embolism + deep vein thrombosis].
The mortality rate was reported to be 18.3%. A high mortality rate was noted in hospitalized people in ordinary wards. In the multivariable assessment, heparin usage was independently linked with survival in people aged ≥ fifty-nine years. People receiving a prophylactic dose of heparin exhibited a reduced bleeding risk when compared to people receiving therapeutic/sub-therapeutic doses.
Internal and Emergency Medicine
Low in-hospital mortality rate in patients with COVID-19 receiving thromboprophylaxis: data from the multicentre observational START-COVID Register
Daniela Poli et al.
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