Patterns of Prophylactic Anticoagulation Among Patients Hospitalized for COVID-19: An Analysis of the American Heart Association COVID-19 Cardiovascular Disease Registry.
Publication Title
J Am Heart Assoc
Document Type
Article
Publication Date
3-4-2025
Keywords
Humans; Male; Female; Anticoagulants; COVID-19; Registries; Aged; Retrospective Studies; United States; Middle Aged; American Heart Association; Hospitalization; SARS-CoV-2; Cardiovascular Diseases; Aged, 80 and over; COVID‐19; SARS‐CoV‐2; anticoagulation; prophylaxis; registry; oregon; cards; cards publication; covid-19
Abstract
BACKGROUND: Limited knowledge exists about prophylactic anticoagulation patterns in patients hospitalized for COVID-19.
METHODS AND RESULTS: We conducted a retrospective cohort study using American Heart Association COVID-19 Cardiovascular Disease Registry data from May 2020 to March 2022. We included patients without preexisting indications for or contraindications to anticoagulation, excluding those with missing anticoagulation data. Patients were categorized by the highest anticoagulation dose received. Multilevel logistic regression was used to assess the relationship between anticoagulation use/dose, patient demographics, clinical presentation, in-hospital course, institutional characteristics, and admission date, accounting for hospital clustering. Among 26 775 patients, 4157 (16%) received no anticoagulation, 15 617 (58%) low-dose, 3071 (11%) intermediate-dose, and 3930 (15%) full-dose anticoagulation. Significant hospital-level variability occurred for any anticoagulation use (range, 0%-98%;
CONCLUSIONS: In this large real-world analysis, nearly 1 in 6 patients hospitalized for COVID-19 received no prophylactic anticoagulation. Patient and disease characteristics associated with thrombotic risk and COVID-19 severity correlated with anticoagulation strategy. Importantly, substantial institutional differences emerged, highlighting gaps between clinical practice and guideline recommendations.
Area of Special Interest
Cardiovascular (Heart)
Specialty/Research Institute
Cardiology
Specialty/Research Institute
Infectious Diseases
Specialty/Research Institute
Pharmacy
DOI
10.1161/JAHA.123.034186
