The effect of oral anticoagulant use before visit for patients with COVID-19 on mortality: A meta-analysis

Abstract

Objectives: Anticoagulants have been used as therapeutic or prophylactic agents in COVID-19 and seem to be more beneficial. However, the advantage of oral anticoagulant (OAC) consumption before visit in lowering mortality in COVID-19 patients remains debatable. This meta-analysis aimed to evaluate the effect of OAC use before visit on mortality using the hazard ratio (HR) to estimate the effect of time-to-event endpoints. Materials and Methods: We conducted a literature search in the PubMed and ProQuest databases for any studies comparing groups consuming OAC to no-OAC before visit for mortality in patients with COVID-19. We calculated the overall HRs and their variances across the studies using the random-effects model to obtain pooled estimates. Results: We included 12 studies which had sample sizes ranging from 70 to 459,402 patients. A meta-analysis comparing OAC therapy and non-OAC consumption in COVID-19 patients before visit revealed no decrease in all-cause mortality (HR = 0.92, 95% confidence interval [CI]: 0.83–1.02, P = 0.12; I2 = 68%). However, subgroup analysis of laboratory-confirmed populations revealed that OAC use before visit had a beneficial effect on mortality (HR = 0.84, 95% CI: 0.73–0.98, P = 0.02; I2 = 56%). Conclusion: The use of OAC before visit had no beneficial effect on all-cause mortality in COVID-19 patients.

Keywords

• anticoagulation
• covid-19
• direct oral anticoagulant
• mortality
• oral anticoagulant