Clinical Outcomes of Direct-Acting Oral Anticoagulants in COVID-19 Patients with Cardiometabolic Comorbidities at a Tertiary Care Hospital
Keywords:
COVID-19, cardiometabolic, anticoagulants, Obesity, thromboembolismAbstract
OBJECTIVE: To evaluate the thrombotic and hemorrhagic outcomes with DOACs in COVID-19 patients with Cardiometabolic diseases that can help in future to treat COVID patients and combat the pandemic.
METHODOLOGY: A descriptive study was conducted among COVID-19 patients in the COVID-19 Isolation Wards and the ICU of Nishtar Medical University, Multan, Pakistan, from January to June 2022. A total of 121 patients who met the inclusion criteria were enrolled in the study. All the patients were put on DOAC therapy, either Rivaroxaban, Apixaban, Edoxaban or Dabigatran. We followed them for up to 30 days after COVID-19 diagnosis to assess the development or absence of thrombotic or hemorrhagic events. Data were analyzed using SPSS 23.
RESULTS: Mean age of the participants was 60.0 ± 10.7 years. Over a period of 30-day follow-up with DOACs, 38.9% of patients developed hemorrhage and 28.9% developed thrombosis. The frequency of thrombosis was significantly higher in males compared to females (36.9% vs 19.6%; p-value 0.037), and higher in obese compared to non-obese (42.1% vs 22.9%, p-value 0.031). The frequency of thrombosis differed significantly among DOACs, with the highest rate in Dabigatran (50%) and the lowest in Rivaroxaban (17.4%).
CONCLUSION: Our study found that haemorrhage occurred in 38.9% of patients on DOACs, and thrombosis was lowest (17.4%) in patients on Rivaroxaban compared to other DOACs. Therefore, Rivaroxaban is associated with a lower frequency of thrombosis.
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