The lowest COVID-19 infection rate was noted with rivaroxaban at 2.38% (n=99, 62% men, average age 62, P<0.00001) ( Figure S1). Significantly lower COVID-19 infection rates were noted among patients on antithrombotic medications, in comparison to those not taking antithrombotics, except enoxaparin ( Table 1). Chi-squared tests were used for statistical analysis.Ī total of 305,981 patients were tested within UC CORDS, with a 3.71% COVID-19 positive test rate (n=11,357, 48% men, average age 42). Data on patients taking common antithrombotic medications at least 14 days prior to COVID-19 testing (to ensure prior use) were collected, including: aspirin, clopidogrel, apixaban, heparin, enoxaparin, rivaroxaban and warfarin. Information regarding patient demographics, COVID-19 testing results, and mortality rates after COVID-19 testing were collected from March 8 to October 8, 2020. This cross-sectional study utilized the University of California COVID-19 Research Data Set (UC CORDS), a HIPAA-limited database of medical records for patients tested for COVID-19 across UC medical centers ( 5). We investigate whether patients with prior antithrombotic use for pre-existing conditions influences COVID-19 infection rates or disease mortality in a California-based population. The use of various regimens of antithrombotics in disease management has been implemented however, the benefit of prior use of antithrombotic medications has not been fully elucidated. Over the past year, preliminary observations on anticoagulant therapy show an association with better outcomes in moderate and severe COVID-19 patients who require mechanical ventilation and have signs of coagulopathy. Interestingly, these FX levels have resulted in an increased tendency to have higher infection rates, increased coagulation and inflammation activation, and fibrosis development ( 2). Coagulation factor X (FX) is a serine protease that is synthesized by the liver, with increased levels reported in patients with cardiopulmonary disease. In critically ill patients, in addition to causing acute respiratory distress syndrome, COVID-19 results in a hypercoagulable state, with extensive thrombosis of the small vessels of the lungs, causing diffuse alveolar damage, and extrapulmonary organs ( 3, 4). COVID-19 has been associated with a prothrombotic state, leading to increased risk of microvascular thrombosis, arterial, or venous thromboembolic disease. This population overlaps significantly with patients who are taking antithrombotics since they are typically older and have comorbidities (coronary artery disease, atrial fibrillation, venous thromboembolism, cerebral vascular attack, or peripheral artery disease) that further increase their risk of severe COVID-19. While some patients are asymptomatic or have mild symptoms when diagnosed with a COVID-19 infection, those who are older, males, or have pre-existing comorbidities (obesity, cardiovascular disease, diabetes, or pulmonary disease) are at increased risk of severe COVID-19 and have higher mortality rates ( 2). Email: 05 November 2021 Accepted: 18 February 2022 Published online: 14 March 2022.Īs COVID-19 infection rates rise worldwide and hospital capacities fall nationwide, increased attention is focused on determining who is most at risk for severe disease ( 1). Dermatology Research Center, University of California, 843 Health Sciences Rd., Hewitt Hall Room 1001, Irvine, CA 92697, USA. Policy of Dealing with Allegations of Research MisconductĬorrespondence to: Cristina Nguyen, MD, MSBS, MHA.Policy of Screening for Plagiarism Process.
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