Value of prophylactic anticoagulation therapy in the 28-day prognosis of severe COVID-19 patients
10.3969/j.issn.1006-5725.2023.21.007
- VernacularTitle:抗凝治疗对重症新型冠状病毒感染患者28d预后的价值
- Author:
Linlin CAO
1
;
Yanmei ZHANG
;
Wanjie ZHA
;
Yuan ZHOU
;
Qitian OU
;
Qiwen HUANG
;
Junde LI
;
Miaoyun WEN
;
Wenhong ZHONG
Author Information
1. 南方医科大学附属广东省人民医院,广东省医学科学院重症医学科 (广州 510080)
- Keywords:
severe;
COVID-19;
prophylactic anticoagulation;
prognosis
- From:
The Journal of Practical Medicine
2023;39(21):2730-2735
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the value of prophylactic anticoagulation in the 28-day prognosis of patients with severe COVID-19.Methods The clinical data of COVID-19 patients admitted to Guangdong Provincial People's Hospital from December 2022 to January 2023 were collected,including age,gender,past medical history,routine blood test,liver and renal function,procalcitonin,coagulation function,Padua prediction score,antiviral therapy,hormonotherapy,immunotherapy and anticoagulation therapy.The patients were divided into an anticoagula-tion group and a non-anticoagulation group.The differences in various indicators were compared between the two groups.Cox regression was performed to assess the independent risk factors for 28-day mortality and the anticoagula-tion efficacy between the subgroups.Results Among 158 patients,128 received anticoagulation;There were significant differences between the two groups in case number of hypertension and critical condition,lymphocyte count,prothrombin time,D-dimer,and case number of immunotherapy.COX logistic regression showed that antico-agulation(HR = 2.25,95%CI:1.01～5.01,P = 0.048)was an independent risk factor for all-cause mortality of COVID-19 patients within 28 days.Subgroup analysis showed that anticoagulation therapy led to an increase in the 28-day mortality as level of procalcitonin of≥0.5 pg/mL(HR = 2.72,95%CI:1.05～7.04)or D-dimer of<2 000 ng/mL(HR = 9.16,95%CI:1.63～51.48).Conclusions Prophylactic anticoagulation did not reduce all-cause mortality of COVID-19 within 28 days.
