دورية أكاديمية
أعرض في EDS

The effect of anti-coagulation dosage on the outcome of hospitalized COVID-19 patients in Ethiopia: a multi-center retrospective cohort study.

التفاصيل البيبلوغرافية
العنوان: The effect of anti-coagulation dosage on the outcome of hospitalized COVID-19 patients in Ethiopia: a multi-center retrospective cohort study.
المؤلفون: Tessema AG; Armauer Hansen Research Institute (AHRI), Addis Ababa, Ethiopia. abelgirma642@gmail.com., Mengiste ZM; Armauer Hansen Research Institute (AHRI), Addis Ababa, Ethiopia., Hundie TG; Eka-Kotebe General Hospital, Addis Ababa, Ethiopia., Yosef HG; Armauer Hansen Research Institute (AHRI), Addis Ababa, Ethiopia., Huluka DK; Addis Ababa University, Addis Ababa, Ethiopia., Seyoum AB; Eka-Kotebe General Hospital, Addis Ababa, Ethiopia., Abate HK; Addis Ababa University, Addis Ababa, Ethiopia., Howe RC; Armauer Hansen Research Institute (AHRI), Addis Ababa, Ethiopia.
المصدر: BMC pulmonary medicine [BMC Pulm Med] 2023 Mar 13; Vol. 23 (1), pp. 85. Date of Electronic Publication: 2023 Mar 13.
نوع المنشور: Multicenter Study; Journal Article
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 100968563 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2466 (Electronic) Linking ISSN: 14712466 NLM ISO Abbreviation: BMC Pulm Med Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : BioMed Central, [2001]-
مواضيع طبية MeSH: COVID-19*, Humans ; Retrospective Studies ; Ethiopia/epidemiology ; SARS-CoV-2 ; Anticoagulants/therapeutic use
مستخلص: Background: Studies have indicated that hospitalized COVID-19 patients benefit from anticoagulation therapy in terms of survival; however, there is an ongoing controversy over the optimum anticoagulant dosage. This study aimed to compare clinical outcomes between patients who received prophylactic anticoagulation and those who received therapeutic anticoagulation.
Methods: A multi-center retrospective cohort study was conducted to determine the impact of anticoagulation dosage in hospitalized COVID-19 patients in Ethiopia. The primary outcome measure was in-hospital mortality, and it was assessed using multivariable binary logistic regression and covariate-adjusted Cox Proportional Hazard model. For critical and severe COVID-19 patients, subgroup analyses were performed using multivariable binary logistic regression model and multivariable Cox regression models.
Result: A total of 472 hospitalized COVID-19 patients were included in this study, of whom 235 (49.8%) received therapeutic anticoagulation and 237 (50.2%) received prophylactic dose. The demographic and baseline clinical characteristics were roughly similar between the groups. After adjustment for several confounders, in critical COVID-19 subgroup, therapeutic dose of anticoagulation was significantly associated with a higher inpatient mortality (AOR 2.27, 95% CI, 1.18-4.35, p = 0.013), whereas in severe COVID-19 subgroup, anticoagulation dosage was not associated with inpatient mortality (OR, 1.02, 95% CI, 0.45 - 2.33, p = 0.958). In severe COVID-19 patient group however, the incidence of thrombosis was slightly lower in the therapeutic group as compared with prophylactic group although the difference was not statistically significant (AOR 0.15, 95% CI, 0.02 - 1.20, p = 0.073). Although there were only six major bleeding events in this study, all these were recorded from patients in the therapeutic subgroup, making the difference statistically significant (p = 0.013).
Conclusion: Although this study is limited by its observational design, our results are not consistent with current recommendations on anti-coagulation dose for hospitalized patients with COVID-19, necessitating the need for RCT in resource limited settings.
(© 2023. The Author(s).)
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فهرسة مساهمة: Keywords: Anticoagulation; Bleeding; COVID-19; Enoxaparin; Ethiopia; Heparin; Thrombosis
المشرفين على المادة: 0 (Anticoagulants)
تواريخ الأحداث: Date Created: 20230314 Date Completed: 20230315 Latest Revision: 20230315
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC10010242
DOI: 10.1186/s12890-023-02375-x
PMID: 36915064
قاعدة البيانات: MEDLINE
الوصف
تدمد:1471-2466
DOI:10.1186/s12890-023-02375-x