Thrombotic and hemorrhagic events in patients with a new coronavirus infection COVID-19 (experience of one center)

Abstract

Introduction. COVID-associated coagulopathy is an important pathogenetic factor in the development of new coronavirus infection (NCI) complications. Therefore the use of anticoagulants is considered as one of the fundamental components of the therapy of NCI. The aim of the study was to find the optimal anticoagulant therapy regimen in patients with severe NCI. Materials and methods. The study is retrospective and included an analysis of 947 cases of confirmed NCI. A survival analysis was performed with the construction of Kaplan-Meyer curves in order to assess the effect of a particular anticoagulant therapy regimen on the occurrence of thrombosis, bleeding, and death. In order to exclude the influence of cofounders due to the retrospective nature of the study, the pseudorandomization method («propensity score matching») was used, followed by the re-construction of Kaplan-Meyer curves. Results. Among 947 patients with severe COVID-19, 27 thrombotic events were verified in 24 patients and 44 hemorrhagic incidents in 38 patients. The day of the event, regardless of the choice of the starting point (the onset of the disease or the 1st day of hospitalization) and its nature (thrombosis or bleeding), had no statistical differences (p=0.33 and p=0.12, respectively). The use of a particular anticoagulant therapy regimen did not significantly affect the development of thrombosis, bleeding or death, including the use of the propensity score matching method. Conclusion. Thus, using therapeutic doses of anticoagulants in COVID-19 patients does not give advantages over the use of preventive doses concerning the risk of thrombosis, bleeding and death.