# Antithrombotic Use Patterns in COVID-19 Patients from Spain: A Real-World Data Study

## TL;DR

This study analyzed how antithrombotics were used in Spain for treating and preventing blood clots in patients with COVID-19, comparing primary care and hospital settings.

## Contribution

The study provides real-world data on antithrombotic use patterns in a large Spanish population during the pandemic.

## Key findings

- Antithrombotics were prescribed to 4.6% of primary care and 53.6% of hospitalized patients with COVID-19.
- Enoxaparin was the most prescribed antithrombotic in hospitals, with higher rates in new users compared to prior users.
- Post-discharge antithrombotic use occurred in 15.9% of patients, with a median duration of 10 days.

## Abstract

Antithrombotics have been widely used to treat and prevent COVID-19-related thrombosis; however, studies on their use at population levels are limited. We aimed to describe antithrombotic use patterns during the pandemic in Spanish primary care and hospital-admitted patients with COVID-19. Methods: A real-world data study was performed. Data were obtained from BIFAP’s electronic health records. We investigated the antithrombotic prescriptions made within ±14 days after diagnosis between March 2020 and February 2022, divided their use into prior and new/naive groups, and reported their post-discharge use. Results: We included 882,540 individuals (53.4% women), of whom 78,499 were hospitalized. The median age was 44.7 (IQR 39–59). Antithrombotics were prescribed in 37,183 (4.6%) primary care subjects and 42,041 (53.6%) hospital-admitted patients, of whom 7505 (20.2%) and 20,300 (48.3%), respectively, were naive users. Prior users were older and had more comorbidities than new users. Enoxaparin was the most prescribed antithrombotic in hospitals, with higher prescription rates in new than prior users (2348.2, IQR 2390–3123.1 vs. 1378, IQR 1162–1751.6 prescriptions per 10,000 cases, p = 0.002). In primary care, acetylsalicylic acid was the most used antithrombotic, with higher use rates in prior than in naïve users. Post-discharge use occurred in 6686 (15.9%) subjects (median use = 10 days, IQR 9-30). Conclusions: Our study identified a consensus on prescribing antithrombotics in COVID-19 patients, but with low use rates in hospitals.