Evidence map›Paper›PMID 34306676›Full record

ArticleAnnals of medicine and surgery (2012)2021

Prevalence, predictors and outcomes of bleeding events in patients with COVID-19 infection on anticoagulation: Retrospective cohort study.

Ahmed Alkhamis, Yousef Alshamali, Khaled Alyaqout, Eisa Lari, Moh A Alkhamis, Saad Althuwaini, Ali Lari, Maryam Alfili, Ali Alkhayat, Mohammad H Jamal and 1 more

Open access · diamondAbstract read
In one paragraph

Article in Annals of medicine and surgery (2012), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.3field-weighted citation impact, top 39% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 6 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 2 institutions in 1 country.

Ahmed AlkhamisDepartment of Surgery, Faculty of Medicine, Health Sciences Center, Kuwait University, Kuwait.
Yousef AlshamaliDepartment of Medicine, Jaber Al-Ahmad Hospital, Kuwait.
Khaled AlyaqoutDepartment of Surgery, Jaber Al-Ahmad Hospital, Kuwait.
Eisa LariDepartment of Surgery, Jaber Al-Ahmad Hospital, Kuwait.
Moh A AlkhamisDepartment of Epidemiology and Biostatistics, Faculty of Public Health, Health Sciences Center, Kuwait University, Kuwait.
Saad AlthuwainiDepartment of Surgery, Jaber Al-Ahmad Hospital, Kuwait.
Ali LariOrthopedic Surgery Department, Al Razi Hospital, Kuwait.
Maryam AlfiliKuwait Ministry of Health, Kuwait.
Ali AlkhayatDepartment of Surgery, Jaber Al-Ahmad Hospital, Kuwait.
Mohammad H JamalDepartment of Surgery, Faculty of Medicine, Health Sciences Center, Kuwait University, Kuwait.
Salman AlsabahDepartment of Surgery, Faculty of Medicine, Health Sciences Center, Kuwait University, Kuwait.
Kuwait University · KWMinistry of Health · KW

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis study aims to examine risk factors and complications associated with bleeding events in patients with COVID-19 who are on anticoagulation. MATERIAL AND

methodsWe conducted retrospective review of all patients who were admitted with COVID-19 and developed bleeding events between March and June 2020. Data were analyzed in accordance with three major outcomes. Mortality within 30 days of bleeding episode, resolution of the bleeding event, and the type of bleeding event.

resultsOf 122 bleeds, there was 55 (28 %) gastrointestinal (GI) bleeds. Overall mortality was 59 % (n = 72). The prevalence of therapeutic invasive interventions was 11.5 % (n = 14) all were successful in resolving the bleeding event. We found that having a GI bleeds was associated with higher risk of mortality compared to non-GI bleeds (p = 0.04) and having occult bleeds to be associated with 15 times increased risk of mortality (OR 15, 95%CI 1.97-29.1, p = 0.01). Furthermore, patients who were on no anticoagulation (none) (OR 0.1, 95%CI 0.01-0.86, p < 0.00), on prophylactic dose anticoagulation (OR 0.07, 95%CI 0.02-0.28, p = 0.03) or intermediate dose anticoagulation (OR 0.36, 95%CI 0.09-1.34, p = 0.13) were less likely to die than patients on therapeutic dose.

conclusionsThe best approach to manage COVID-19 bleeding patients is to prioritize therapies that manage sepsis induce coagulopathy and shock over other approaches. In COVID-19 patients' routine prescription of supra-prophylactic dose anticoagulation should be revisited and more individualized approach to prescription should be the norm. Regardless of the cause of bleeding event it appears that the majority of bleeding events resolve with noninvasive interventions and when invasive interventions were necessary, they were associated with high success rate despite the delay.

Indexed as

AnticoagulationBleedingCOVID-19DoseMortality

Identifiers

PMID34306676
PMCPMC8294630
OpenAlexW3183233473

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.