{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T16:12:37Z","timestamp":1768407157000,"version":"3.49.0"},"reference-count":10,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2025,4,5]],"date-time":"2025-04-05T00:00:00Z","timestamp":1743811200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,4,5]],"date-time":"2025-04-05T00:00:00Z","timestamp":1743811200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Bristol Myers Squibb\u2013 Pfizer alliance","award":["CV185-805"],"award-info":[{"award-number":["CV185-805"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Thromb Thrombolysis"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>Long COVID (LC) or post-acute sequelae of SARS-CoV-2 infection (PASC) is defined as ongoing, relapsing or new symptoms\/conditions persisting after an acute COVID-19 infection. Given the potential role of oral anticoagulants (OAC) in treating thrombotic sequelae of LC\/PASC, we investigated whether prevalent OAC use at the time of acute COVID-19 infection was associated with reduced development of LC\/PASC. Retrospective cohort study within the TriNetx network. The primary cohort was defined as adults with a confirmed diagnosis of COVID-19. We defined OAC users as those who had received OACs (either direct-acting OACs [DOACs] or vitamin K antagonists [VKA]) in the preceding 3-months and non-users as those without OAC use within the previous 12-months. The primary outcome was a composite of 9 features associated with LC\/PASC We identified 38,409 DOAC users, 19,243 VKA users, and 2,329,771 non-OAC users with acute COVID-19 infection. After successful propensity score matching (PSM), we found an increased risk of LC\/PASC features in those receiving DOAC compared to non-OAC (HR [95% CI] 1.50 [1.35 to 1.68], <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001), and in VKA users compared to non-OACs (HR [95% CI] 1.98 [1.78 to 2.20], <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001), while DOAC users were at reduced risk compared to VKA users (HR [95% CI] 0.71 [0.62 to 0.81], <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). We found no evidence that prevalent OAC at the time of acute COVID-19 infection was associated with reduced risk of LC\/PASC. Further work is needed to understand whether there is a role for OAC therapy in the management of LC\/PASC.<\/jats:p>","DOI":"10.1007\/s11239-025-03096-0","type":"journal-article","created":{"date-parts":[[2025,4,6]],"date-time":"2025-04-06T02:47:14Z","timestamp":1743907634000},"page":"585-589","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The use of oral anticoagulation at the time of acute COVID-19 infection and subsequent development of long-COVID\/post-acute sequelae of SARS-CoV-2 infection"],"prefix":"10.1007","volume":"58","author":[{"given":"Freddy","family":"Frost","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 Miguel","family":"Rivera-Caravaca","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory Y. H.","family":"Lip","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,4,5]]},"reference":[{"issue":"9","key":"3096_CR1","doi-asserted-by":"publisher","first-page":"e1003773","DOI":"10.1371\/journal.pmed.1003773","volume":"18","author":"M Taquet","year":"2021","unstructured":"Taquet M, Dercon Q, Luciano S, Geddes JR, Husain M, Harrison PJ (2021) Incidence, co-occurrence, and evolution of long-COVID features: A 6-month retrospective cohort study of 273,618 survivors of COVID-19. PLoS Med 18(9):e1003773","journal-title":"PLoS Med"},{"issue":"20","key":"3096_CR2","doi-asserted-by":"publisher","first-page":"2838","DOI":"10.1182\/blood.2020010529","volume":"137","author":"D Giannis","year":"2021","unstructured":"Giannis D, Allen SL, Tsang J, Flint S, Pinhasov T, Williams S et al (2021) Postdischarge thromboembolic outcomes and mortality of hospitalized patients with COVID-19: the CORE-19 registry. Blood 137(20):2838\u20132847","journal-title":"Blood"},{"issue":"3","key":"3096_CR3","doi-asserted-by":"publisher","first-page":"756","DOI":"10.1182\/bloodadvances.2020003968","volume":"5","author":"FA von Meijenfeldt","year":"2021","unstructured":"von Meijenfeldt FA, Havervall S, Adelmeijer J, Lundstr\u00f6m A, Magnusson M, Mackman N et al (2021) Sustained prothrombotic changes in COVID-19 patients 4 months after hospital discharge. Blood Adv 5(3):756\u2013759","journal-title":"Blood Adv"},{"key":"3096_CR4","doi-asserted-by":"publisher","first-page":"714426","DOI":"10.3389\/fmed.2021.714426","volume":"8","author":"E Pasini","year":"2021","unstructured":"Pasini E, Corsetti G, Romano C, Scarabelli TM, Chen-Scarabelli C, Saravolatz L et al (2021) Serum metabolic profile in patients with Long-Covid (PASC) syndrome: clinical implications. Front Med (Lausanne) 8:714426","journal-title":"Front Med (Lausanne)"},{"key":"3096_CR5","unstructured":"Treatment of Long COVID symptoms with triple anticoagulant therapy [Internet] 2023 [cited 2023 Sep 20]. Available from: https:\/\/www.researchsquare.com"},{"issue":"23","key":"3096_CR6","doi-asserted-by":"publisher","first-page":"1976","DOI":"10.1136\/heartjnl-2017-312228","volume":"104","author":"D Capodanno","year":"2018","unstructured":"Capodanno D (2018) Triple antithrombotic therapy after ACS and PCI in patients on chronic oral anticoagulation: update. Heart 104(23):1976\u20131983","journal-title":"Heart"},{"key":"3096_CR7","doi-asserted-by":"publisher","first-page":"861703","DOI":"10.3389\/fcimb.2022.861703","volume":"12","author":"C Wang","year":"2022","unstructured":"Wang C, Yu C, Jing H et al (2022) Long COVID: the nature of thrombotic sequelae determines the necessity of early anticoagulation. Front Cell Infect Microbiol 12:861703","journal-title":"Front Cell Infect Microbiol"},{"issue":"1","key":"3096_CR8","doi-asserted-by":"publisher","first-page":"e0324","DOI":"10.1097\/CCE.0000000000000324","volume":"3","author":"RF Harrison","year":"2021","unstructured":"Harrison RF, Forte K, Buscher MG Jr et al (2021) The association of preinfection daily oral anticoagulation use and all-Cause in hospital mortality from novel coronavirus 2019 at 21 days: a retrospective cohort study. Crit Care Explor 3(1):e0324","journal-title":"Crit Care Explor"},{"issue":"10319","key":"3096_CR9","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1016\/S0140-6736(21)02392-8","volume":"399","author":"E Ramacciotti","year":"2022","unstructured":"Ramacciotti E, Barile Agati L, Calderaro D et al (2022) Rivaroxaban versus no anticoagulation for post-discharge thromboprophylaxis after hospitalisation for COVID-19 (MICHELLE): an open-label, multicentre, randomised, controlled trial. Lancet 399(10319):50\u201359","journal-title":"Lancet"},{"issue":"2","key":"3096_CR10","doi-asserted-by":"publisher","first-page":"292","DOI":"10.1002\/rth2.12485","volume":"5","author":"H Eswaran","year":"2021","unstructured":"Eswaran H, Jarmul JA, Shaheen AW et al (2021) Vascular thromboembolic events following COVID-19 hospital discharge: incidence and risk factors. Res Pract Thromb Haemost 5(2):292\u2013295","journal-title":"Res Pract Thromb Haemost"}],"container-title":["Journal of Thrombosis and Thrombolysis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11239-025-03096-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11239-025-03096-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11239-025-03096-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T02:11:51Z","timestamp":1746065511000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11239-025-03096-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,5]]},"references-count":10,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,4]]}},"alternative-id":["3096"],"URL":"https:\/\/doi.org\/10.1007\/s11239-025-03096-0","relation":{},"ISSN":["1573-742X"],"issn-type":[{"value":"1573-742X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,5]]},"assertion":[{"value":"27 March 2025","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 April 2025","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"JMR-C: Consultant for Idorsia Pharmaceuticals LTD. FF: Speaker for Chiesi, Vertex Pharmaceuticals and Astrazeneca. GYHL: Consultant and speaker for BMS\/Pfizer, Boehringer Ingelheim, Anthos and Daiichi-Sankyo. No fees are received personally. GYHL is a National Institute for Health and Care Research (NIHR) Senior Investigator and co-principal investigator of the AFFIRMO project on multimorbidity in AF, which has received funding from the European Union\u2019s Horizon 2020 research and innovation programme under grant agreement No 899871.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}