Quality of evidence: B-
Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy
Authors: Ning T et al
Journal: Journal of thrombosis and Haemostasis
Objectives: Assess the effect of anticoagulation drugs on the death rate in severe cases with coagulopathy
Strength of evidence: Moderate (medium cohort, restrospective)
Methods/publication type:
Retrospective study
Tongji (1st January to 13 February)
Coagulopathy stratified by the sepsis-induced coagulopathy (SIC) score or D-dimer result.
449 patients with severe COVID-19, 99 received heparin
Main outcome: 28-day mortality between heparin users and nonusers
Highlights :
60.6% of patients had a chronic underlying disease (39.4% hypertension, 20.7% diabetes, 9.1% heart disease)
No significant difference in mortality at 28 days between the treated and non=treated groups without stratification (30.3% vs 29.7%, P = 0.910)
21.6% of patients had a sepsis-induced coagulopathy (SIC) score ≥4
The 28-day mortality between heparin users and nonusers of heparin were compared in stratified patients and were lower in heparin users with SIC score ≥4 (mortality: 40.0% vs 64.2%, P=0.029) or D-dimer > 3.0 ug/mL (mortality : 32.8% vs 52.4%, P=0.017)
The D-dimer, prothrombin time and age were positively, and platelet count was negatively, correlated with 28-day mortality
Heparin might be recommended only for a specific population at risk (SIC score ≥ 4 and/or D-dimer > 3.0 ug/mL)
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