Daniel J Lachant1, Neil A Lachant2, Peter Kouides2, Stephen Rappaport3, Paritosh Prasad1,4, R James White1. 1. Division of Pulmonary and Critical Care Medicine, University of Rochester Medical Center, Rochester, New York, USA. 2. Division of Hematology, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York, USA. 3. Department of Pharmacy, University of Rochester Medical Center, Rochester, New York, USA. 4. Division of Transplant Infectious Disease, University of Rochester Medical Center, Rochester, New York, USA.
Abstract
BACKGROUND: Thrombotic disease complicates severe SARS-CoV-2 infection and is associated with increased morbidity and mortality. Various anticoagulation strategies have been evaluated in hospitalized patients to prevent complications. The impact of chronic anticoagulation before SARS-CoV-2 infection on the risk for subsequent thrombosis has not been systematically studied. METHODS: This was a retrospective single-center study. All patients with positive SARS-CoV-2 PCR testing from March 13, 2020, through May 6, 2020, at the University of Rochester Medical Center were identified. We included all patients receiving therapeutic anticoagulation for at least 1 month before COVID diagnosis. We documented the rate of thrombotic complications, type of anticoagulation, bleeding complications, and mortality. RESULTS: A total of 107 SARS-CoV2-infected patients were chronically anticoagulated before SARS-CoV-2 testing with a median age of 78. Of those, 42 required hospital admission, with 17 requiring intensive care. No patients, inpatient or outpatient, were diagnosed with a new symptomatic thrombotic complication. Three patients had minor bleeding in the hospital. Thirteen (12%) patients died (69% male). CONCLUSION: Our uncontrolled findings suggest that chronic anticoagulation at the time of infection may protect against thrombotic complications and decrease disease severity.
BACKGROUND:Thrombotic disease complicates severe SARS-CoV-2 infection and is associated with increased morbidity and mortality. Various anticoagulation strategies have been evaluated in hospitalized patients to prevent complications. The impact of chronic anticoagulation before SARS-CoV-2 infection on the risk for subsequent thrombosis has not been systematically studied. METHODS: This was a retrospective single-center study. All patients with positive SARS-CoV-2 PCR testing from March 13, 2020, through May 6, 2020, at the University of Rochester Medical Center were identified. We included all patients receiving therapeutic anticoagulation for at least 1 month before COVID diagnosis. We documented the rate of thrombotic complications, type of anticoagulation, bleeding complications, and mortality. RESULTS: A total of 107 SARS-CoV2-infectedpatients were chronically anticoagulated before SARS-CoV-2 testing with a median age of 78. Of those, 42 required hospital admission, with 17 requiring intensive care. No patients, inpatient or outpatient, were diagnosed with a new symptomatic thrombotic complication. Three patients had minor bleeding in the hospital. Thirteen (12%) patientsdied (69% male). CONCLUSION: Our uncontrolled findings suggest that chronic anticoagulation at the time of infection may protect against thrombotic complications and decrease disease severity.
Authors: Janneke P Spiegelenberg; Marleen M H J van Gelder; Martje L Maas; Marcel M C Hovens; Anne Esselink; Anton S M Dofferhoff; Rob Janssen; Josephine van de Maat; Nico Janssen; Marc Blaauw; Robert-Jan Hassing; Marjan van Apeldoorn; Angèle Kerckhoffs; Karin Veerman; Jacobien Hoogerwerf; Cornelis Kramers; Jenneke Leentjens Journal: Br J Clin Pharmacol Date: 2021-05-07 Impact factor: 3.716
Authors: Sameh M Hozayen; Diana Zychowski; Sydney Benson; Pamela L Lutsey; Jasmin Haslbauer; Alexandar Tzankov; Zachary Kaltenborn; Michael Usher; Surbhi Shah; Christopher J Tignanelli; Ryan T Demmer Journal: EClinicalMedicine Date: 2021-09-24
Authors: Daniel Lachant; Dominick Roto; Stephen Rappaport; Paritosh Prasad; Neil Lachant; R James White Journal: Thromb Res Date: 2021-07-03 Impact factor: 3.944