National Trends in Anticoagulation Therapy for COVID-19 Hospitalized Adults in the United States: Analyses of the National COVID Cohort Collaborative.
BACKGROUND: Anticoagulation (AC) utilization patterns and their predictors among hospitalized coronavirus disease 2019 (COVID-19) patients have not been well-described.
METHODS: Using the National COVID Cohort Collaborative, we conducted a retrospective cohort study (2020-2022) to assess AC use patterns and identify factors associated with therapeutic AC employing modified Poisson regression.
RESULTS: Among 162,842 hospitalized COVID-19 patients, 64% received AC and 24% received therapeutic AC. Therapeutic AC use declined from 32% in 2020 to 12% in 2022, especially after December 2021. Therapeutic AC predictors included age (relative risk (RR), 1.02 [95% confidence interval (CI), 1.02-1.02] per year), male (RR, 1.29 [1.27-1.32]), Non-Hispanic Black (RR, 1.16 [1.13-1.18]), obesity (RR, 1.48 [1.43-1.52]), increased length of stay (RR, 1.01; [1.01-1.01] per day), and invasive ventilation (RR, 1.64 [1.59-1.69]). Vaccination (RR, 0.88 [0.84-0.92]) and higher Charlson Comorbidity Index (CCI) (RR, 0.98 [0.97-0.98]) were associated with lower therapeutic AC.
CONCLUSIONS: Overall, two thirds of hospitalized COVID-19 patients received any AC and a quarter received therapeutic dosing. Therapeutic AC declined after the introduction of the Omicron variant. Predictors of therapeutic AC included demographics, obesity, LOS, invasive ventilation, CCI, and vaccination, suggesting AC decisions driven by clinical factors including COVID-19 severity, bleeding risks, and comorbidities.
Published In/Presented At
Lee, E., Bates, B., Kuhrt, N., Andersen, K. M., Visaria, A., Patel, R., Setoguchi, S., & N3C Consortium (2023). National Trends in Anticoagulation Therapy for COVID-19 Hospitalized Adults in the United States: Analyses of the National COVID Cohort Collaborative. The Journal of infectious diseases, jiad194. Advance online publication. https://doi.org/10.1093/infdis/jiad194
Medicine and Health Sciences
Department of Medicine, Fellows and Residents