|
?:abstract
|
-
SESSION TITLE: Late-breaking Abstract Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: The SARS-CoV-2 coronavirus (COVID-19) infection can be associated with coagulopathy and a high incidence of thromboembolic events Our study investigated the impact of full dose anticoagulation versus standard prophylaxis anticoagulation in hospitalized, predominantly Black patients with COVID-19 infection METHODS: This is a retrospective observational study based on chart review of patients admitted to the University Hospital of Brooklyn in New York City from March 23rd, 2020 through April 23rd, 2020 Inclusion criteria included age ≥ 18 years, confirmed COVID-19 infection, and available baseline D-dimer level Patients were studied under two groups: full dose anticoagulant (AC) versus prophylactic dose (non-AC) The variables collected included demographics, comorbidities, laboratory results, type of anticoagulation, major bleeds, and Sepsis-Induced Coagulopathy (SIC) score Follow-up clinic and telehealth visit notes were utilized to establish survival at 28 days RESULTS: A total of 138 hospitalized patients met the inclusion criteria 119 (86 2%) were Black, 77 (56%) were males, 60 (44%) were females, and the average age of all was 66 6 years 120 (85 5%) received full dose AC Median hospital course for all patients was 12 days [IQR 7 00 to 24 25] Kaplan Meier median survival was 25 days for AC group [95% CI 21 9-28 1] and 9 days [95% CI 6 4–11 6] for non-AC Unadjusted proportional hazard ratio (HR) showed that full dose AC resulted in decreased mortality with a HR of 0 387 [95% CI 0 204 - 0 734;p=0 004], with multivariate proportional hazard adjusted for D-dimer, SIC score and CRP level of 0 159 [HR=0 159, 95% CI 0 070 - 0 361;p<0 001] Patients who received full dose AC had higher D-dimer, CRP and SIC scores at baseline Survival based on agent used showed no difference between direct oral anticoagulants (DOAC) and low molecular weight heparin (LMWH) Kaplan Meier median survival for DOAC was 20 days (95% CI 11 1-28 9) versus LMWH median survival of 25 days (95% CI 17 7-32 3) AC was stopped in a total of 11 patients (9 for major bleeds, 2 for down trending hemoglobin);with a Pearson’s chi-square=4 716 (p=0 09) which is statistically insignificant CONCLUSIONS: In hospitalized patients with SARS-CoV-2 infection, administration of full dose anticoagulation showed a 28-day survival benefit in a predominantly Black population, especially those with a higher D-dimer, CRP, and SIC score at baseline Further investigation with a randomized control trial of full dose anticoagulation in COVID -19 infection is warranted CLINICAL IMPLICATIONS: Empiric full dose anticoagulation has a role to play in the clinical management of high-risk hospitalized patients with COVID -19 infection while awaiting definitive therapies DISCLOSURES: No relevant relationships by rishard abdul, source=Web Response No relevant relationships by Alla akivis, source=Web Response No relevant relationships by Yonatan Akivis, source=Web Response No relevant relationships by Aaliya Burza, source=Web Response No relevant relationships by Michael Farina, source=Web Response No relevant relationships by Bana Hadid, source=Web Response No relevant relationships by Ishmam Ibtida, source=Web Response No relevant relationships by Sridesh Nath, source=Web Response No relevant relationships by Yara Perez, source=Web Response No relevant relationships by Duarxy Sainvilien, source=Web Response No relevant relationships by Ghassan Samaha, source=Web Response No relevant relationships by Baho Sidiqi, source=Web Response No relevant relationships by Maya Srinivasan, source=Web Response No relevant relationships by Samrat Worah, source=Web Response No relevant relationships by Unaiza Zaman, source=Web Response
|
![[This page as RDF]](https://research.tib.eu/covid-19/static/rdf-icon.gif){kind=icon}