COVID-19 scan for September 27, 2021

Anticoagulants linked to reduction in COVID hospitalizations, deaths

According to a study published late last week, taking anticoagulants before contracting COVID-19 is associated with a reduced risk of hospitalization by 43% and receiving anticoagulants in hospital is linked to a lower death rate. EClinicalMedicine.

The researchers created a retrospective cohort of 6,195 adults with COVID-19 at M Health Fairview hospitals and clinics in the Midwestern United States from March 4 to August 27, 2020. Of these, 598 were immediately hospitalized and the rest were hospitalized. was initially treated on an outpatient basis. Overall, the case fatality was 2.8%, with inpatients having a death rate of 13%, and the researchers note that 5.9% of outpatients eventually had to be hospitalized.

Multivariate analysis showed that the 2.9% of outpatients on anticoagulant therapy 90 days before COVID-19 were associated with a 43% reduction in the risk of hospitalization (95% confidence interval [CI], 0.38 to 0.86; p = 0.007) but no mortality (hazard ratio [HR], 0.88; 95% CI: 0.50 to 1.62; p = 0.64). If patients did not start anticoagulant therapy during hospitalization or continued outpatient anticoagulation after being hospitalized, they had a higher risk of mortality (RR: 2.26; 95% CI: 1.17 to 4, 37; p = 0.015). Stratification by prophylactic / prophylactic or progressive therapeutic initiation versus continuation of anticoagulant therapy showed HRs of 1.24 and 1.45, respectively, with p > 0.30.

“Although our study does not have the power to study bleeding complications, the comparable death rates between those who were put on anticoagulation or who were continued on anticoagulation are reassuring. As in other studies, people with high levels of D-dimer had an increased risk of death, ”the researchers explain. write.

“To date, there is no consensus on the type of anticoagulant, the dosage or the duration of treatment. Randomized controlled trials for anticoagulant therapy in inpatients and outpatients are urgently needed to answer these critical questions for COVID-19 patients.
Sep 24 EClinicalMedicine to study

COVID-19 hospitalization rate linked to poverty and race

The prevalence of COVID-related hospitalizations at the start of the pandemic was linked to poverty and minority status in the United States, according to a study published in PLOS A at the end of last week.

Researchers are looking at COVID-19-related hospitalizations in the United States from March 1 to April 30, 2020, using COVID-NET data, which covers about 10% of the nation’s population in 14 states. Of 16,000 adults hospitalized with COVID-19, 34.8% were White, 36.3% were Black, and 18.2% were Hispanics or Latinos. Age-adjusted COVID-related hospitalizations were higher in census tracts with 15.2% to 83.2% of those living below the federal poverty line compared to census tracts where 0% to 4.9% were (151.6 hospitalizations per 100,000 people versus 75.5).

The prevalence of hospitalization also appears to be affected by race. Whites, blacks, and Hispanics living in high poverty census tracts recorded 120.3, 252.2, and 341.1 hospitalizations per 100,000 people, respectively, and researchers found even greater racial disparities in low poverty census tracts. When poverty and minority status overlapped, Hispanics and blacks had hospitalization rates 9.2 and 5.3 times higher than whites, respectively (304.0 and 540.3 hospitalizations versus 58.2 per 100,000 people).

“Because hospitalization rates among blacks and Hispanics were high regardless of poverty in census tracts, racial / ethnic disparities in hospitalization rates were greatest in low poverty census tracts. “, write the researchers. “Public health practitioners should ensure that mitigation measures and vaccination campaigns meet the social, behavioral and medical needs of racial / ethnic minority groups and people living in census tracts with socio-economic indicators. lower economic. “

The researchers add that 33.1% of inpatients were in the top quartile of service industry workers, 30.8% were in the top quartile of public transport commuters, and 30.0% were in the top quartile of people in the service industry. 25 years or older who did not have a bachelor’s degree.
Sep 24 PLOS Open to study

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