{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,9]],"date-time":"2025-11-09T03:47:50Z","timestamp":1762660070334,"version":"3.41.2"},"reference-count":16,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,5,13]],"date-time":"2021-05-13T00:00:00Z","timestamp":1620864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:p><jats:bold>Objective:<\/jats:bold> Altered coagulation parameters in COVID-19 patients is associated with a poor prognosis. We tested whether COVID-19 patients on chronic oral anticoagulants (cOACs) for thromboembolism prophylaxis could receive protection from developing more severe phenotypes of the disease.<\/jats:p><jats:p><jats:bold>Approach and Results:<\/jats:bold> We searched the database of the SARS-RAS study (<jats:ext-link>Clinicaltrials.gov<\/jats:ext-link>: NCT04331574), a cross-sectional observational multicenter nationwide survey in Italy designed by the Italian Society of Hypertension. The database counts 2,377 charts of Italian COVID-19 patients in 26 hospitals. We calculated the Charlson comorbidity index (CCI), which is associated with death in COVID-19 patients. In our population (<jats:italic>n<\/jats:italic> = 2,377, age 68.2 \u00b1 0.4 years, CCI: 3.04 \u00b1 0.04), we confirm that CCI is associated with increased mortality [OR: 1.756 (1.628-1.894)], admission to intensive care units [ICU; OR: 1.074 (1.017-1.134)], and combined hard events [CHE; OR: 1.277 (1.215-1.342)]. One hundred twenty-five patients were on cOACs (age: 79.3 \u00b1 0.9 years, CCI: 4.35 \u00b1 0.13); despite the higher CCI, cOACs patients presented with a lower risk of admissions to the ICU [OR 0.469 (0.250-0.880)] but not of death [OR: 1.306 (0.78-2.188)] or CHE [OR: 0.843 (0.541-1.312)]. In multivariable logistic regression, cOACs confirmed their protective effect on ICU admission and CHE. The CCI remains the most important risk factor for ICU admission, death, and CHE.<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> Our data support a mechanism for the continuation of cOAC therapy after hospital admission for those patients who are on chronic treatment. Our preliminary results suggest the prophylactic use of direct cOACs in patients with elevated CCI score at the time of the COVID-19 pandemic even in absence of other risks of thromboembolism.<\/jats:p>","DOI":"10.3389\/fcvm.2021.633878","type":"journal-article","created":{"date-parts":[[2021,5,13]],"date-time":"2021-05-13T04:25:33Z","timestamp":1620879933000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":11,"title":["Preexisting Oral Anticoagulant Therapy Ameliorates Prognosis in Hospitalized COVID-19 Patients"],"prefix":"10.3389","volume":"8","author":[{"given":"Guido","family":"Iaccarino","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guido","family":"Grassi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudio","family":"Borghi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Davide","family":"Grassi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Costantino","family":"Mancusi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Lorenza","family":"Muiesan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Massimo","family":"Salvetti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Massimo","family":"Volpe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudio","family":"Ferri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,5,13]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"2052","DOI":"10.1001\/jama.2020.6775","article-title":"Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York city area","volume":"323","author":"Richardson","year":"2020","journal-title":"JAMA."},{"key":"B2","first-page":"e35","article-title":"Prevalence of underlying diseases in hospitalized patients with COVID-19: a systematic review and meta-analysis","volume":"8","author":"Emami","year":"2020","journal-title":"Arch Acad Emerg Med"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1421","DOI":"10.1111\/jth.14830","article-title":"Prevalence of venous thromboembolism in patients with severe novel coronavirus pneumonia","volume":"18","author":"Cui","year":"2020","journal-title":"J Thromb Haemost"},{"key":"B4","doi-asserted-by":"publisher","first-page":"844","DOI":"10.1111\/jth.14768","article-title":"Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia","volume":"18","author":"Tang","year":"2020","journal-title":"J Thromb Haemost"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1417","DOI":"10.3390\/jcm9051417","article-title":"Hypertension thrombosis, kidney failure, and diabetes: is COVID-19 an endothelial disease? a comprehensive evaluation of clinical and basic evidence","volume":"9","author":"Sardu","year":"2020","journal-title":"J Clin Med"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1094","DOI":"10.1111\/jth.14817","article-title":"Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy","volume":"18","author":"Tang","year":"2020","journal-title":"J Thromb Haemost"},{"key":"B7","doi-asserted-by":"publisher","first-page":"846","DOI":"10.1111\/bjh.16727","article-title":"Thromboembolic risk and anticoagulant therapy in COVID-19 patients: emerging evidence and call for action","volume":"189","author":"Kollias","year":"2020","journal-title":"Br J Haematol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1007\/s11239-020-02138-z","article-title":"Thromboembolism and anticoagulant therapy during the COVID-19 pandemic: interim clinical guidance from the anticoagulation forum","volume":"50","author":"Barnes","year":"2020","journal-title":"J Thromb Thrombolysis"},{"key":"B9","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1007\/s40292-020-00380-3","article-title":"Renin-angiotensin system inhibition in cardiovascular patients at the time of COVID19: much ado for nothing? A Statement of Activity from the Directors of the Board and the Scientific Directors of the Italian Society of Hypertension","volume":"27","author":"Iaccarino","year":"2020","journal-title":"High Blood Press Cardiovasc Prev"},{"year":"2020","key":"B10","article-title":"Clinical Management Of Severe Acute Respiratory Infection When Novel Coronavirus (Ncov) Infection Is Suspected: Interim Guidance"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1239","DOI":"10.1001\/jama.2020.2648","article-title":"Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72314 cases from the Chinese Center for Disease Control and Prevention","volume":"323","author":"Wu","year":"2020","journal-title":"JAMA."},{"key":"B12","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1016\/0021-9681(87)90171-8","article-title":"A new method of classifying prognostic comorbidity in longitudinal studies: development and validation","volume":"40","author":"Charlson","year":"1987","journal-title":"J Chronic Dis"},{"key":"B13","doi-asserted-by":"publisher","first-page":"2950","DOI":"10.1016\/j.jacc.2020.04.031","article-title":"Right ventricular: COVID-19 and thrombotic or thromboembolic disease: implications for prevention, antithrombotic therapy, and follow-up: JACC state-of-the-art review","volume":"75","author":"Bikdeli","year":"2020","journal-title":"J Am Coll Cardiol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.thromres.2021.01.005","article-title":"Mechanisms of thrombosis and cardiovascular complications in COVID-19","volume":"200","author":"Page","year":"2021","journal-title":"Thromb Res"},{"key":"B15","doi-asserted-by":"publisher","first-page":"e192","DOI":"10.1111\/bjh.16968","article-title":"COVID-19 mortality in patients on anticoagulants and antiplatelet agents","volume":"190","author":"Sivaloganathan","year":"2020","journal-title":"Br J Haematol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"104965","DOI":"10.1016\/j.phrs.2020.104965","article-title":"Clinical impact of pre-admission antithrombotic therapy in hospitalized patients with COVID-19: a multicenter observational study","volume":"159","author":"Russo","year":"2020","journal-title":"Pharmacol Res"}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2021.633878\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,5,13]],"date-time":"2021-05-13T04:25:40Z","timestamp":1620879940000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2021.633878\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,13]]},"references-count":16,"alternative-id":["10.3389\/fcvm.2021.633878"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2021.633878","relation":{},"ISSN":["2297-055X"],"issn-type":[{"type":"electronic","value":"2297-055X"}],"subject":[],"published":{"date-parts":[[2021,5,13]]},"article-number":"633878"}}