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Effect of previous anticoagulant treatment on risk of COVID-19

Effect of previous anticoagulant treatment on risk of COVID-19
Effect of previous anticoagulant treatment on risk of COVID-19
Introduction: little is known about the role played by anticoagulants in COVID-19.

Objective: the aim of this study was to assess the impact of previous anticoagulant treatment on risk of hospitalization due to COVID-19, progression to severe COVID-19 and susceptibility to COVID-19 infection.

Methods: we conducted a multiple population-based case–control study in northwest Spain, in 2020, to assess (1) risk of hospitalization: cases were all patients admitted due to COVID-19 with PCR confirmation, and controls were a random matched sample of subjects without a positive PCR; (2) progression: cases were hospitalized COVID-19 subjects, and controls were all non-hospitalized COVID-19 patients; and (3) susceptibility: cases were patients with a positive PCR (hospitalized and non-hospitalized), and the controls were the same as for the hospitalization model. Adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated using a generalized linear mixed model.

Results: the consumption of antivitamin K and direct-acting anticoagulants apparently was not associated with the risk of progression to severe COVID-19 (OR 0.93 [95% CI 0.74–1.17] and OR 1.04 [95% CI 0.79–1.36], respectively). Antivitamin K anticoagulants were associated with a significantly lower risk of hospitalization (OR 0.77 [95% CI 0.64–0.93]), which, in part, can be explained by a decreased risk of susceptibility to infection (OR 0.83 [95% CI 0.74–0.92]). The use of direct-acting anticoagulants was not associated with the risk of hospitalization, although it also seems to decrease susceptibility (OR 0.85 [95% CI 0.74–0.98]). It has also been observed that low-molecular-weight heparins were associated with an increased risk of progression to severe COVID-19 (OR 1.25 [95% CI 1.01–1.55]).

Conclusion: the results of this study have shown that antivitamin K anticoagulants and direct-acting anticoagulants do not increase the risk of progression to more severe stages. Antivitamin K consumption was associated with a lower risk of hospitalization and susceptibility to infection.
0114-5916
273-281
Zapata-Cachafeiro, Maruxa
d2ea345c-f77d-4f09-8fe2-d0c2071cd486
Prieto-Campo, Ángela
2216b51b-eee9-4e49-81ad-af1850f0333b
Portela-Romero, Manuel
58c5325c-9e4a-46f4-bb73-171a5f2e7fbe
Carracedo-Martínez, Eduardo
896c40b1-8434-417a-96b2-3ebe8eff2008
Lema-Oreiro, Martina
e84479fe-89cb-42fc-b710-ba43ce61ce46
Piñeiro-Lamas, María
ba5872c3-f3a6-4fc8-a971-e0cc66b5807d
Chaudhuri, Somnath
ae0507e0-f920-4438-bc9f-ecdd5ac8967a
Salgado-Barreira, Ángel
6e625021-f512-4b77-8cf7-6e5944f009b5
Figueiras, Adolfo
e48548cf-17d8-43b8-a221-049443806402
Zapata-Cachafeiro, Maruxa
d2ea345c-f77d-4f09-8fe2-d0c2071cd486
Prieto-Campo, Ángela
2216b51b-eee9-4e49-81ad-af1850f0333b
Portela-Romero, Manuel
58c5325c-9e4a-46f4-bb73-171a5f2e7fbe
Carracedo-Martínez, Eduardo
896c40b1-8434-417a-96b2-3ebe8eff2008
Lema-Oreiro, Martina
e84479fe-89cb-42fc-b710-ba43ce61ce46
Piñeiro-Lamas, María
ba5872c3-f3a6-4fc8-a971-e0cc66b5807d
Chaudhuri, Somnath
ae0507e0-f920-4438-bc9f-ecdd5ac8967a
Salgado-Barreira, Ángel
6e625021-f512-4b77-8cf7-6e5944f009b5
Figueiras, Adolfo
e48548cf-17d8-43b8-a221-049443806402

Zapata-Cachafeiro, Maruxa, Prieto-Campo, Ángela, Portela-Romero, Manuel, Carracedo-Martínez, Eduardo, Lema-Oreiro, Martina, Piñeiro-Lamas, María, Chaudhuri, Somnath, Salgado-Barreira, Ángel and Figueiras, Adolfo (2022) Effect of previous anticoagulant treatment on risk of COVID-19. Drug Safety, 46, 273-281. (doi:10.1007/s40264-022-01266-0).

Record type: Article

Abstract

Introduction: little is known about the role played by anticoagulants in COVID-19.

Objective: the aim of this study was to assess the impact of previous anticoagulant treatment on risk of hospitalization due to COVID-19, progression to severe COVID-19 and susceptibility to COVID-19 infection.

Methods: we conducted a multiple population-based case–control study in northwest Spain, in 2020, to assess (1) risk of hospitalization: cases were all patients admitted due to COVID-19 with PCR confirmation, and controls were a random matched sample of subjects without a positive PCR; (2) progression: cases were hospitalized COVID-19 subjects, and controls were all non-hospitalized COVID-19 patients; and (3) susceptibility: cases were patients with a positive PCR (hospitalized and non-hospitalized), and the controls were the same as for the hospitalization model. Adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated using a generalized linear mixed model.

Results: the consumption of antivitamin K and direct-acting anticoagulants apparently was not associated with the risk of progression to severe COVID-19 (OR 0.93 [95% CI 0.74–1.17] and OR 1.04 [95% CI 0.79–1.36], respectively). Antivitamin K anticoagulants were associated with a significantly lower risk of hospitalization (OR 0.77 [95% CI 0.64–0.93]), which, in part, can be explained by a decreased risk of susceptibility to infection (OR 0.83 [95% CI 0.74–0.92]). The use of direct-acting anticoagulants was not associated with the risk of hospitalization, although it also seems to decrease susceptibility (OR 0.85 [95% CI 0.74–0.98]). It has also been observed that low-molecular-weight heparins were associated with an increased risk of progression to severe COVID-19 (OR 1.25 [95% CI 1.01–1.55]).

Conclusion: the results of this study have shown that antivitamin K anticoagulants and direct-acting anticoagulants do not increase the risk of progression to more severe stages. Antivitamin K consumption was associated with a lower risk of hospitalization and susceptibility to infection.

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Accepted/In Press date: 29 November 2022
Published date: 23 December 2022

Identifiers

Local EPrints ID: 502894
URI: http://eprints.soton.ac.uk/id/eprint/502894
ISSN: 0114-5916
PURE UUID: 2f14222b-944a-46d8-9c84-bb4f21c95612
ORCID for Somnath Chaudhuri: ORCID iD orcid.org/0000-0003-4899-1870

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Date deposited: 11 Jul 2025 16:31
Last modified: 22 Aug 2025 02:43

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Contributors

Author: Maruxa Zapata-Cachafeiro
Author: Ángela Prieto-Campo
Author: Manuel Portela-Romero
Author: Eduardo Carracedo-Martínez
Author: Martina Lema-Oreiro
Author: María Piñeiro-Lamas
Author: Somnath Chaudhuri ORCID iD
Author: Ángel Salgado-Barreira
Author: Adolfo Figueiras

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