# Anticoagulant Use in COVID-19 Patients: A Longitudinal Study From Zanjan, Iran

## TL;DR

This study from Iran found that using anticoagulants and aspirin in hospitalized COVID-19 patients did not reduce deaths or ICU admissions, though anticoagulants might help reduce ICU admissions.

## Contribution

The study provides new insights into anticoagulant use and outcomes in Iranian hospitalized COVID-19 patients.

## Key findings

- Mortality was higher in older patients, males, and those with ICU admission or comorbidities.
- Combined aspirin and anticoagulant use was linked to higher ICU admission and mortality rates.
- Anticoagulant use alone was associated with a potential decrease in ICU admissions.

## Abstract

Background

The mortality and morbidity of thrombotic events in patients with coronavirus disease 2019 (COVID-19) are increasing worldwide. The clinical impact of prophylactic anticoagulation regimens among these patients in Iran remains unclear. This study aimed to evaluate the use of prophylactic anticoagulants and outcomes among COVID-19 patients admitted to a tertiary referral hospital.

Methodology

Patients diagnosed with COVID-19 and hospitalized between March 20 and June 20, 2020, were included in this longitudinal study after obtaining informed consent. Demographic and clinical data were collected from the hospital information system and medical records. Outcomes during this period were also evaluated. The data were entered into the preparation checklist and analyzed using SPSS version 24 software (IBM Corp., Armonk, NY, USA), employing chi-square, Fisher’s exact, and Mann-Whitney U tests.

Results

Of the 831 enrolled patients, 51.9% were female, and 10.6% needed to be admitted to the intensive care unit (ICU). The mean age of the patients was 57.16 ± 17.32 years, and the mortality rate was estimated to be 9.4%. Mortality rates were significantly higher at older ages, in men, patients with ICU admission, severe pulmonary involvement, malignancy, airway obstruction, ischemic heart disease, and previous cerebrovascular accidents. ICU admission and mortality were statistically significantly higher in those who received concurrent prophylactic anticoagulants and aspirin than in other individuals.

Conclusions

Our study demonstrated that administering prophylactic aspirin with or without anticoagulant agents in COVID-19 patients did not reduce mortality rates or ICU transfers. However, it is worth noting that anticoagulant prescription was associated with a decrease in ICU admissions, which could potentially alleviate the significantly higher mortality rates observed among ICU patients in this study. Further research is needed to explore the potential benefits of anticoagulants in COVID-19 treatment.