ArticleJournal of thrombosis and thrombolysis2022
Direct oral anticoagulant plasma levels in hospitalized COVID-19 patients treated with dexamethasone.
Article in Journal of thrombosis and thrombolysis, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 21 citations in OpenAlex.
- [Drug-drug interactions in critically ill patients].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025Review
- Ischemic Stroke in Patients Under Oral Anticoagulation: The Achilles Heel of Atrial Fibrillation Management.Brain sciences · 2025Review
- The Impact of Dexamethasone and Prednisone on Apixaban and Rivaroxaban Exposure in COVID-19 Patients: A Physiologically Based Pharmacokinetic Modeling Study.Clinical pharmacology and therapeutics · 2025Article
- Dexamethasone: a cheap and convenient way to alleviate subsequent stenosis after thermal injury on ureter.Translational andrology and urology · 2024Article
- Management of Patients Receiving Anticoagulation Therapy in Dental Practice: A Systematic Review.Healthcare (Basel, Switzerland) · 2024Review
- Drug-Drug Interactions Involving Dexamethasone in Clinical Practice: Myth or Reality?Journal of clinical medicine · 2023Review
- DrugResearch and practice in thrombosis and haemostasis · 2023Review
- Article
- Good practice statements for antithrombotic therapy in the management of COVID-19: Guidance from the SSC of the ISTH.Journal of thrombosis and haemostasis : JTH · 2022Article
- Targeting the NLRP3 inflammasome in cardiovascular diseases.Pharmacology & therapeutics · 2022Review
- Acute Coronary Syndrome in the COVID-19 Era-Differences and Dilemmas Compared to the Pre-COVID-19 Era.Journal of clinical medicine · 2022Review
- NLRP3 inflammasome activation and SARS-CoV-2-mediated hyperinflammation, cytokine storm and neurological syndromes.International journal of physiology, pathophysiology and pharmacology · 2022Review
- COVID-19 Coagulopathy: From Pathogenesis to Treatment.Acta haematologica · 2022Review
- Impact of New Onset Atrial Fibrillation in Hospitalized Patients with COVID-19. Results of the "ACO-VID" Registry.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisArticle
- Edoxaban Versus Low-Molecular-Weight Heparin in Hospitalized COVID-19 Patients With Atrial Fibrillation.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisObservational
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Direct oral anticoagulants (DOACs) are not recommended in COVID-19 patients receiving dexamethasone because of potential drug-drug and drug-disease interactions affecting anticoagulant concentration and activity. To evaluate short- and long-term pharmacokinetic interactions, serial through and peak DOAC plasma levels were prospectively measured during and after dexamethasone therapy, as well as during the acute phase and after recovery from COVID-19 in hospitalized, non-critically ill patients undergoing treatment with DOACs. Thirty-three (18 males, mean age 79 years) consecutive patients received DOACs (17 apixaban, 12 rivaroxaban, 4 edoxaban) for atrial fibrillation (n = 22), venous thromboembolism (n = 10), and acute myocardial infarction (n = 1). Twenty-six patients also received dexamethasone at a dose of 6 mg once daily for a median of 14 days. Trough DOAC levels on dexamethasone were within and below expected reference ranges respectively in 87.5 and 8.3% of patients, with no statistically significant differences at 48-72 h and 14-21 days after dexamethasone discontinuation. Peak DOAC levels on dexamethasone were within expected reference ranges in 58.3% of patients, and below ranges in 33.3%, of whom over two thirds had low values also off dexamethasone. No significant differences in DOAC levels were found during hospitalization and after resolution of COVID-19. Overall, 28 patients were discharged alive, and none experienced thrombotic or bleeding events. In this study, dexamethasone administration or acute COVID-19 seemed not to affect DOAC levels in hospitalized, non-critically ill COVID-19 patients.
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