ArticleClinical research in cardiology : official journal of the German Cardiac Society2021
Impact of oral anticoagulation on clinical outcomes of COVID-19: a nationwide cohort study of hospitalized patients in Germany.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 7 of them syntheses that pooled it.
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Who cites it
38 citing papers in PubMed, 7 syntheses or guidelines pooled it, 62 citations in OpenAlex.
- Renin-Angiotensin Aldosterone System Inhibitors and COVID-19: A Systematic Review and Meta-Analysis Revealing Critical Bias Across a Body of Observational Research.Journal of the American Heart Association · 2022Pooled it
- The effect of previous oral anticoagulant use on clinical outcomes in COVID-19: A systematic review and meta-analysis.The American journal of emergency medicine · 2022Pooled it
- Anticoagulants for people hospitalised with COVID-19: a rapid reviewThe Cochrane database of systematic reviews · 2022Pooled it
- Antiplatelet therapy for patients with COVID-19: Systematic review and meta-analysis of observational studies and randomized controlled trials.Frontiers in medicine · 2022Pooled it
- Associations between the use of aspirin or other antiplatelet drugs and all-cause mortality among patients with COVID-19: A meta-analysis.Frontiers in pharmacology · 2022Pooled it
- The Use of Oral Anticoagulation Is Not Associated With a Reduced Risk of Mortality in Patients With COVID-19: A Systematic Review and Meta-Analysis of Cohort Studies.Frontiers in pharmacology · 2022Pooled it
- Use of antiplatelet drugs and the risk of mortality in patients with COVID-19: a meta-analysis.Journal of thrombosis and thrombolysis · 2021Pooled it
- Therapeutic Anticoagulation with Heparin in Noncritically Ill Patients with Covid-19.The New England journal of medicine · 2021Trial
- The use of extracorporeal membrane oxygenation in COVID-19: a systematic review.Archives of medical science : AMS · 2025Review
- Anticoagulant use before COVID-19 diagnosis prevent COVID-19 associated acute venous thromboembolism or not: A systematic review and meta-analysis.World journal of methodology · 2024Article
- Current status and clinical outcomes of pharmacotherapies according to SARS-CoV-2 mutations in patients with mild-to-moderate COVID-19: a retrospective single center study.BMC infectious diseases · 2024Article
- Death and Venous Thromboembolism Analyses among Hospitalized COVID-19-Positive Patients: A Multicenter Study.Journal of clinical medicine · 2023Article
- Effect of Previous Anticoagulant Treatment on Risk of COVID-19.Drug safety · 2023Article
- COVID-19 and comedications in atrial fibrillation-a case-control study in Stockholm.European journal of epidemiology · 2023Article
- Risks associated with prior oral anticoagulation use in hospitalized COVID-19 patients - A retrospective cohort study on 5392 patients from a tertiary centre.International journal of cardiology · 2023Article
- Clinical Outcomes of Anticoagulant Therapy in COVID-19 Patients with Pre-Existing Cardiovascular Diseases: A Systematic Review.Infection and drug resistance · 2023Review
- Cytokine Release Syndrome (CRS) in Severe COVID-19 Patients: Two Controversial and Interesting Case Reports and Literature Review.Tanaffos · 2023Article
- Low molecular weight heparin in COVID-19: benefits and concerns.Frontiers in pharmacology · 2023Review
- The Collateral Benefit of COVID Pandemic: Improved Pharmacological Venous Thromboembolism Prophylaxis Practices in Non-COVID Patients.International journal of general medicine · 2023Article
- Preadmission Oral Anticoagulation for Atrial Fibrillation/Flutter and Death or Thrombotic Events During COVID-19 Admission.The American journal of cardiology · 2022Article
Corrections and comments
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Authors and funding
11 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe aim of this study was to investigate the impact of concomitant long-term medication-with a focus on ACE inhibitors and oral anticoagulation-on clinical outcomes in patients hospitalized with coronavirus disease 2019.
methodsThis is a retrospective cohort study using claims data of the biggest German health insurance company AOK, covering 26.9 million people all over Germany. In particular, patient-related characteristics and co-medication were evaluated. A multivariable logistic regression model was adopted to identify independent predictors for the primary outcome measure of all-cause mortality or need for invasive or non-invasive ventilation or extracorporeal membrane oxygenation.
results6637 patients in 853 German hospitals were included. The primary outcome occurred in 1826 patients (27.5%). 1372 patients (20.7%) died, 886 patients (13.3%) needed respiratory support, and 53 patients (0.8%) received extracorporeal membrane oxygenation. 34 of these patients survived (64.2%). The multivariable model demonstrated that pre-existing oral anticoagulation therapy with either vitamin-K antagonists OR 0.57 (95% CI 0.40-0.83, p = 0.003) or direct oral anticoagulants OR 0.71 (95% CI 0.56-0.91, p = 0.007)-but not with antiplatelet therapy alone OR 1.10 (95% CI 0.88-1.23, p = 0.66)-was associated with a lower event rate. This finding was confirmed in a propensity match analysis.
conclusionsIn a multivariable analysis, a therapy with both direct oral anticoagulants or vitamin-K antagonists-but not with antiplatelet therapy-was associated with improved clinical outcomes. ACE inhibitors did not impact outcomes. Prospective randomized trials are needed to verify this hypothesis.
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