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

Moudhi Alroomi 1, Ahmad Alsaber 2, Bader Al-Bader 3, Farah Almutairi 3, Haya Malhas 4, Jiazhu Pan 2, Kobalava D Zhanna 5, Maryam Ramadhan 6, Mohammad Al Saleh 3, Mohammed Abdullah 1, Naser Alotaibi 7, Noor AlNasrallah 7, Rajesh Rajan 8, Soumoud Hussein 9, Wael Aboelhassan 10

Affiliations

01 January 2022

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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%.

Keywords: COVID-19; SARS-CoV-2; anticoagulation; in-hospital mortality; pneumonia.

Figures

Figure 1. Study flowchart.

Figure 1. Study flowchart.

Figure 2. Kaplan-Meier method-estimated morality rates, stratified by anticoagulation status, depending on time since admission.

Figure 2. Kaplan-Meier method-estimated morality rates, stratified by anticoagulation status, depending on time since admission.

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KMEL References

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