Anticoagulant use before COVID-19 diagnosis prevent COVID-19 associated acute venous thromboembolism or not:A systematic review and meta-analysis

作     者：Kinza Iqbal Akshat Banga Taha Bin Arif Sawai Singh Rathore Abhishek Bhurwal Syeda Kisa Batool Naqvi Muhammad Mehdi Pankaj Kumar Mitali Madhu Salklan Ayman Iqbal Jawad Ahmed Nikhil Sharma Amos Lal Rahul Kashyap Vikas Bansal Juan Pablo Domecq 

作者机构：Department of Internal MedicineDow Medical CollegeKarachi 74200Pakistan Department of Internal MedicineSawai Man Singh Medical CollegeJaipur 302004India Department of Internal MedicineDr.Sampurnanand Medical CollegeJodhpur 342003RajasthanIndia Department of Gastroenterology and HepatologyRutgers Robert Wood Johnson School of MedicineNew BrunswickNJ 08901United States Department of Internal MedicinePandit Bhagwat Dayal Sharma Post Graduate Institute of Medical SciencesRohtak 124001HaryanaIndia Department of Nephrology and HypertensionMayo ClinicRochesterMN 55905United States Department of MedicineDivision of Pulmonary and Critical Care MedicineMayo ClinicRochesterMN 55905United States Department of ResearchWellspan HealthYorkPA 17403United States 

出 版 物：《World Journal of Methodology》 (世界方法学杂志)

年 卷 期：2024年第14卷第3期

页      面：141-162页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Prior anticoagulation COVID-19 Prehospital anticoagulation Chronic anticoagulation Mortality Severity Thromboembolic events 

摘      要：BACKGROUND Coagulopathy and thromboembolic events are associated with poor outcomes in coronavirus disease 2019(COVID-19)*** is conflicting evidence on the effects of chronic anticoagulation on mortality and severity of COVID-19 *** To summarize the body of evidence on the effects of pre-hospital anticoagulation on outcomes in COVID-19 *** A Literature search was performed on LitCovid PubMed,WHO,and Scopus databases from inception(December 2019)till June 2023 for original studies reporting an association between prior use of anticoagulants and patient outcomes in adults with *** primary outcome was the risk of thromboembolic events in COVID-19 patients taking *** outcomes included COVID-19 disease severity,in terms of intensive care unit admission or invasive mechanical ventilation/intubation requirement in patients hospitalized with COVID-19 infection,and *** random effects models were used to calculate crude and adjusted odds ratios(aORs)with 95%confidence intervals(95%CIs).RESULTS Forty-six observational studies met our inclusion *** unadjusted analysis found no association between prior anticoagulation and thromboembolic event risk[n=43851,9 studies,odds ratio(OR)=0.67(0.22,2.07);P=0.49;I2=95%].The association between prior anticoagulation and disease severity was non-significant[n=186782;22 studies,OR=1.08(0.78,1.49);P=0.64;I2=89%].However,pre-hospital anticoagulation significantly increased all-cause mortality risk[n=207292;35 studies,OR=1.72(1.37,2.17);P0.00001;I2=93%].Pooling adjusted estimates revealed a statistically non-significant association between pre-hospital anticoagulation and thromboembolic event risk[aOR=0.87(0.42,1.80);P=0.71],mortality[aOR=0.94(0.84,1.05);P=0.31],and disease severity[aOR=0.96(0.72,1.26);P=0.76].CONCLUSION Prehospital anticoagulation was not significantly associated with reduced risk of thromboembolic events,improved survival,and lower disease seve