Bleeding and thrombosis outcomes in hospitalised COVID-19 patients on low-molecular-weight heparin and antiplatelet therapy
S. Afr. med. j
; 112(7): 472-477, 2022. figures, tables
Artigo
em Inglês
| AIM (África)
| ID: biblio-1378229
Biblioteca responsável:
CG1.1
ABSTRACT
Background. An increased incidence of thromboembolic events in hospitalised COVID19 patients has been demonstrated despite the use of low-molecular-weight heparin (LMWH). Antiplatelet therapy prior to admission and early in the disease course has been hypothesised to be protective against thrombosis.Objectives. To describe the bleeding and thrombosis outcomes in hospitalised patients with confirmed COVID19 receiving LMWH, with and without concomitant antiplatelet therapy. Secondary objectives were to explore predictors of bleeding and thrombosis outcomes, and dosing practices of antiplatelet therapy and LMWH.Methods. We conducted a descriptive, cross-sectional study of bleeding and thrombosis outcomes at Tygerberg Academic Hospital, Cape Town, South Africa, during the first COVID19 wave, in 808 hospitalised patients with confirmed COVID19 receiving LMWH with and without concomitant antiplatelet therapy. Multivariate logistic regression analysis was performed if predictors were deemed statistically and clinically significant.Results. Patients receiving both LMWH and antiplatelet therapy had similar bleeding outcomes compared with patients only receiving LMWH (odds ratio (OR) 1.5; 95% confidence interval (CI) 0.6 - 4.0). Patients receiving both LMWH and antiplatelet therapy had increased odds of developing thrombosis compared with patients only receiving LMWH (OR 4.8; 95% CI 2.1 - 10.7).Conclusion. The bleeding risk in COVID19 patients receiving both LMWH and antiplatelet therapy was not significantly increased. A potentially higher risk of thrombosis in patients receiving LMWH and antiplatelet therapy was observed. However, this could reflect confounding by indication. Randomised studies are required to further evaluate the use of antiplatelet therapy to treat hospitalised patients with COVID19.
Texto completo:
Disponível
Base de dados:
AIM (África)
Assunto principal:
Trombose
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Inibidores da Agregação Plaquetária
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COVID-19
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Hemorragia
Tipo de estudo:
Ensaio clínico controlado
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Estudo observacional
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Estudo prognóstico
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Fatores de risco
Limite:
Feminino
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Humanos
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Masculino
Idioma:
Inglês
Revista:
S. Afr. med. j
Ano de publicação:
2022
Tipo de documento:
Artigo
Instituição/País de afiliação:
Division of Clinical Pharmacology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University/ZA
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Division of Clinical Pharmacology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town/ZA
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Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University/ZA
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Division of General Internal Medicine, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University/ZA
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Division of Infectious Diseases, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University/ZA