Pierre Ménager1,2, Olivier Brière2, Jennifer Gautier2, Jérémie Riou3,4, Guillaume Sacco2, Antoine Brangier2, Cédric Annweiler1,2,5,6,7, On Behalf Of The Geria-Covid Study Group. 1. Department of Geriatric Medicine, Le Mans Hospital, F-72037 Le Mans, France. 2. Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity, University Hospital, F-49933 Angers, France. 3. INSERM, MINT, 1066, University of Angers, F-49000 Angers, France. 4. Delegation to Clinical Research and Innovation, Angers University Hospital, F-49933 Angers, France. 5. UPRES EA 4638, University of Angers, F-49000 Angers, France. 6. Gérontopôle Autonomie Longévité des Pays de la Loire, F-44000 Nantes, France. 7. Robarts Research Institute, Department of Medical Biophysics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON N6A 5K8, Canada.
Abstract
BACKGROUND: Vitamin K concentrations are inversely associated with the clinical severity of COVID-19. The objective of this cohort study was to determine whether the regular use of vitamin K antagonist (VKA) prior to COVID-19 was associated with short-term mortality in frail older adults hospitalized for COVID-19. METHODS: Eighty-two patients consecutively hospitalized for COVID-19 in a geriatric acute care unit were included. The association of the regular use of VKA prior to COVID-19 with survival after 7 days of COVID-19 was examined using a propensity-score-weighted Cox proportional-hazards model accounting for age, sex, severe undernutrition, diabetes mellitus, hypertension, prior myocardial infarction, congestive heart failure, prior stroke and/or transient ischemic attack, CHA2DS2-VASc score, HAS-BLED score, and eGFR. RESULTS: Among 82 patients (mean ± SD age 88.8 ± 4.5 years; 48% women), 73 survived COVID-19 at day 7 while 9 died. There was no between-group difference at baseline, despite a trend for more frequent use of VKA in those who did not survive on day 7 (33.3% versus 8.2%, p = 0.056). While considering "using no VKA" as the reference (hazard ratio (HR) = 1), the HR for 7-day mortality in those regularly using VKA was 5.68 [95% CI: 1.17; 27.53]. Consistently, COVID-19 patients using VKA on a regular basis had shorter survival times than the others (p = 0.031). CONCLUSIONS: Regular use of VKA was associated with increased mortality at day 7 in hospitalized frail elderly patients with COVID-19.
BACKGROUND:Vitamin K concentrations are inversely associated with the clinical severity of COVID-19. The objective of this cohort study was to determine whether the regular use of vitamin K antagonist (VKA) prior to COVID-19 was associated with short-term mortality in frail older adults hospitalized for COVID-19. METHODS: Eighty-two patients consecutively hospitalized for COVID-19 in a geriatric acute care unit were included. The association of the regular use of VKA prior to COVID-19 with survival after 7 days of COVID-19 was examined using a propensity-score-weighted Cox proportional-hazards model accounting for age, sex, severe undernutrition, diabetes mellitus, hypertension, prior myocardial infarction, congestive heart failure, prior stroke and/or transient ischemic attack, CHA2DS2-VASc score, HAS-BLED score, and eGFR. RESULTS: Among 82 patients (mean ± SD age 88.8 ± 4.5 years; 48% women), 73 survived COVID-19 at day 7 while 9 died. There was no between-group difference at baseline, despite a trend for more frequent use of VKA in those who did not survive on day 7 (33.3% versus 8.2%, p = 0.056). While considering "using no VKA" as the reference (hazard ratio (HR) = 1), the HR for 7-day mortality in those regularly using VKA was 5.68 [95% CI: 1.17; 27.53]. Consistently, COVID-19patients using VKA on a regular basis had shorter survival times than the others (p = 0.031). CONCLUSIONS: Regular use of VKA was associated with increased mortality at day 7 in hospitalized frail elderly patients with COVID-19.
Entities:
Keywords:
COVID-19; SARS-CoV-2; anticoagulation; older adults; survival; vitamin K antagonist
Authors: Alex C Spyropoulos; Jean M Connors; James D Douketis; Mark Goldin; Beverley J Hunt; Taiwo R Kotila; Renato D Lopes; Sam Schulman Journal: J Thromb Haemost Date: 2022-07-29 Impact factor: 16.036
Authors: Marcin Protasiewicz; Konrad Reszka; Wojciech Kosowski; Barbara Adamik; Wojciech Bombala; Adrian Doroszko; Damian Gajecki; Jakub Gawryś; Maciej Guziński; Maria Jedrzejczyk; Krzysztof Kaliszewski; Katarzyna Kilis-Pstrusinska; Bogusława Konopska; Agnieszka Kopec; Krzysztof Kujawa; Anna Langner; Anna Larysz; Weronika Lis; Lilla Pawlik-Sobecka; Joanna Gorka-Dynysiewicz; Marta Rosiek-Biegus; Agnieszka Matera-Witkiewicz; Tomasz Matys; Michał Pomorski; Mateusz Sokolski; Janusz Sokołowski; Anna Tomasiewicz-Zapolska; Katarzyna Madziarska; Ewa A Jankowska Journal: J Clin Med Date: 2022-01-12 Impact factor: 4.241