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In-hospital Mortality Rates in SARS-CoV-2 Patients Treated with Enoxaparin and Heparin

Alroomi M 1 , Alsaber A 2 , Al-Bader B 3 , Almutairi F 3 , Malhas H 4 , Pan J 2 Show all authors , Zhanna KD 5 , Ramadhan M 6 , Saleh MA 3 , Abdullah M 1 , Alotaibi N 7 , AlNasrallah N 7 , Rajan R 8 , Hussein S 9 , Aboelhassan W 10

Affiliations 

  • 1 Department of Infectious Diseases, Infectious Diseases Hospital, Shuwaikh Medical Area, Kuwait
  • 2 Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK
  • 3 Department of Medicine, Farwaniya Hospital, Farwaniya, Kuwait
  • 4 Department of Medicine, Mubarak Al-Kabeer Hospital, Jabriya, Kuwait
  • 5 Department of Internal Medicine with the Subspecialty of Cardiology and Functional Diagnostics Named after V.S. Moiseev, Institute of Medicine, Peoples' Friendship University of Russia (RUDN University), Moscow, Russian Federation
  • 6 Department of Obstetrics and Gynaecology, Maternity Hospital, Shuwaikh Medical Area, Kuwait
  • 7 Department of Medicine, Al Adan Hospital, Hadiya, Kuwait
  • 8 Department of Cardiology, Sabah Al Ahmed Cardiac Centre, Al Amiri Hospital, Kuwait City, Kuwait
  • 9 Department of Medicine, Al Amiri Hospital, Kuwait City, Kuwait
  • 10 Division of Gastroenterology, Department of Medicine, Jaber Al Ahmed Hospital, South Surra, Kuwait
Clin Appl Thromb Hemost, 2022;28:10760296221131802.
PMID: 36285386 DOI: 10.1177/10760296221131802

Abstract

OBJECTIVES: This study aimed to investigate in-hospital mortality rates in patients with coronavirus disease (COVID-19) according to enoxaparin and heparin use.

METHODS: This retrospective cohort study included 962 patients admitted to two hospitals in Kuwait with a confirmed diagnosis of COVID-19. Cumulative all-cause mortality rate was the primary outcome.

RESULTS: A total of 302 patients (males, 196 [64.9%]; mean age, 57.2 ± 14.6 years; mean body mass index, 29.8 ± 6.5 kg/m2) received anticoagulation therapy. Patients receiving anticoagulation treatment tended to have pneumonia (n = 275 [91.1%]) or acute respiratory distress syndrome (n = 106 [35.1%]), and high D-dimer levels (median [interquartile range]: 608 [523;707] ng/mL). The mortality rate in this group was high (n = 63 [20.9%]). Multivariable logistic regression, the Cox proportional hazards, and Kaplan-Meier models revealed that the use of therapeutic anticoagulation agents affected the risk of all-cause cumulative mortality.

CONCLUSION: Age, hypertension, pneumonia, therapeutic anticoagulation, and methylprednisolone use were found to be strong predictors of in-hospital mortality. In elderly hypertensive COVID-19 patients on therapeutic anticoagulation were found to have 2.3 times higher risk of in-hospital mortality. All cause in-hospital mortality rate in the therapeutic anticoagulation group was up to 21%.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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