Skip to Main content Skip to Navigation
Journal articles

Anticoagulation prior to hospitalization is a potential protective factor for COVID-19: insight from a French multicenter cohort study

Richard Chocron 1, 2 Vincent Galand 3, 4 Joffrey Cellier 1, 2 Nicolas Gendron 2, 5 Thibaut Pommier 6 Olivier Bory 1, 2 Lina Khider 7, 2 Antonin Trimaille 8 Guillaume Goudot 7, 2 Orianne Weizman 9, 1, 2 Jean Marc Alsac 5, 2 Laura Geneste 10 Armand Schmeltz 2 Vassili Panagides 11 Aurélien Philippe 5, 2 Wassima Marsou 12 Iannis Ben Abdallah 5, 2 Antoine Deney 13 Salma El Batti 5, 2 Sabir Attou 14 Philippe Juvin 2 Stephane Delmotte 15 Emmanuel Messas 1, 2 Théo Pezel 16 Benjamin Planquette 2 Baptiste Duceau 1, 2 Pascale Gaussem 2 Willy Sutter 1, 2 Olivier Sanchez 2 Victor Waldman 1, 2 Jean-Luc Diehl 2 Tristan Mirault 1, 2 Guillaume Bonnet 1, 2 Ariel Cohen 17 David M Smadja 2
Abstract : Background Coronavirus disease 2019 (COVID-19) is a respiratory disease associated with thrombotic outcomes with coagulation and endothelial disorders. Based on that, several anticoagulation guidelines have been proposed. We aimed to determine whether anticoagulation therapy modifies the risk of developing severe COVID-19. Methods and Results Patients with COVID-19 initially admitted in medical wards of 24 French hospitals were included prospectively from February 26 to April 20, 2020. We used a Poisson regression model, Cox proportional hazard model, and matched propensity score to assess the effect of anticoagulation on outcomes (intensive care unit admission or in-hospital mortality). The study enrolled 2878 patients with COVID-19, among whom 382 (13.2%) were treated with oral anticoagulation therapy before hospitalization. After adjustment, anticoagulation therapy before hospitalization was associated with a better prognosis with an adjusted hazard ratio of 0.70 (95% CI, 0.55-0.88). Analyses performed using propensity score matching confirmed that anticoagulation therapy before hospitalization was associated with a better prognosis, with an adjusted hazard ratio of 0.43 (95% CI, 0.29-0.63) for intensive care unit admission and adjusted hazard ratio of 0.76 (95% CI, 0.61-0.98) for composite criteria intensive care unit admission or death. In contrast, therapeutic or prophylactic low- or high-dose anticoagulation started during hospitalization were not associated with any of the outcomes. Conclusions Anticoagulation therapy used before hospitalization in medical wards was associated with a better prognosis in contrast with anticoagulation initiated during hospitalization. Anticoagulation therapy introduced in early disease could better prevent COVID-19-associated coagulopathy and endotheliopathy, and lead to a better prognosis.
Document type :
Journal articles
Complete list of metadata

https://hal.archives-ouvertes.fr/hal-03190837
Contributor : Laurent Jonchère <>
Submitted on : Tuesday, April 6, 2021 - 4:31:01 PM
Last modification on : Wednesday, June 9, 2021 - 4:02:06 PM

Links full text

Identifiers

Citation

Richard Chocron, Vincent Galand, Joffrey Cellier, Nicolas Gendron, Thibaut Pommier, et al.. Anticoagulation prior to hospitalization is a potential protective factor for COVID-19: insight from a French multicenter cohort study. Journal of the American Heart Association, Wiley-Blackwell, 2021, pp.e018288. ⟨10.1161/JAHA.120.018624⟩. ⟨hal-03190837⟩

Share

Metrics

Record views

57