Anticoagulation and Covid19 infection

In view of the observation that Covid19 infection as associated with VTE at an incidence of up to 30%, researchers have recently examined the possibility that early initiation of prophylactic anticoagulation may decrease the likelihood of death among hospitalised patients infected with the virus.In an observational study of a nationwide cohort of patients a complete cohort of 4297 patients admitted to hospital from 1 March to 31 July 2020 with laboratory confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and without a history of anticoagulation were followed. 3627 (84.4%) received prophylactic anticoagulation within 24 hours of admission (mostly SC heparin or enoxaparin.) 622 deaths occurred within 30 days of hospital admission, and 513 of those who received prophylactic anticoagulation died. The cumulative incidence of mortality at 30 days was 14.3% (95% confidence interval 13.1% to 15.5%) among those who received prophylactic anticoagulation and 18.7% (15.1% to 22.9%) among those who did not. Prophylactic anticoagulation was not associated with increased risk of bleeding requiring transfusion (hazard ratio 0.87, 0.71 to 1.05). The researchers advocate that the early use of anticoagulation appears warranted for those infected and hospitalised. See the study details here.