{"title":"COVID-19患者就诊前口服抗凝剂对死亡率的影响:一项荟萃分析","authors":"Cornelia Ghea, Ardyan Wardhana, Alfredo Nugroho, Fika Humaeda Assilmi","doi":"10.4103/tcmj.tcmj_199_22","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Anticoagulants have been used as therapeutic or prophylactic agents in COVID-19 and seem to be more beneficial. However, the advantage of oral anticoagulant (OAC) consumption before visit in lowering mortality in COVID-19 patients remains debatable. This meta-analysis aimed to evaluate the effect of OAC use before visit on mortality using the hazard ratio (HR) to estimate the effect of time-to-event endpoints.</p><p><strong>Materials and methods: </strong>We conducted a literature search in the PubMed and ProQuest databases for any studies comparing groups consuming OAC to no-OAC before visit for mortality in patients with COVID-19. We calculated the overall HRs and their variances across the studies using the random-effects model to obtain pooled estimates.</p><p><strong>Results: </strong>We included 12 studies which had sample sizes ranging from 70 to 459,402 patients. A meta-analysis comparing OAC therapy and non-OAC consumption in COVID-19 patients before visit revealed no decrease in all-cause mortality (HR = 0.92, 95% confidence interval [CI]: 0.83-1.02, <i>P</i> = 0.12; <i>I</i><sup>2</sup> = 68%). However, subgroup analysis of laboratory-confirmed populations revealed that OAC use before visit had a beneficial effect on mortality (HR = 0.84, 95% CI: 0.73-0.98, <i>P</i> = 0.02; <i>I</i><sup>2</sup> = 56%).</p><p><strong>Conclusion: </strong>The use of OAC before visit had no beneficial effect on all-cause mortality in COVID-19 patients.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"35 3","pages":"226-230"},"PeriodicalIF":1.4000,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/67/81/TCMJ-35-226.PMC10399847.pdf","citationCount":"0","resultStr":"{\"title\":\"The effect of oral anticoagulant use before visit for patients with COVID-19 on mortality: A meta-analysis.\",\"authors\":\"Cornelia Ghea, Ardyan Wardhana, Alfredo Nugroho, Fika Humaeda Assilmi\",\"doi\":\"10.4103/tcmj.tcmj_199_22\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>Anticoagulants have been used as therapeutic or prophylactic agents in COVID-19 and seem to be more beneficial. 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引用次数: 0
摘要
目的:抗凝血剂已被用作COVID-19的治疗或预防药物，似乎更有益。然而，就诊前口服抗凝剂(OAC)在降低COVID-19患者死亡率方面的优势仍存在争议。本荟萃分析旨在评估就诊前使用OAC对死亡率的影响，使用风险比(HR)来估计时间到事件终点的影响。材料和方法:我们在PubMed和ProQuest数据库中进行了文献检索，以比较就诊前服用OAC组和未服用OAC组对COVID-19患者死亡率的影响。我们使用随机效应模型计算了所有研究的总体hr及其方差，以获得汇总估计。结果:我们纳入了12项研究，样本量从70到459,402例患者。一项比较就诊前COVID-19患者OAC治疗和非OAC治疗的荟萃分析显示，全因死亡率没有下降(HR = 0.92, 95%可信区间[CI]: 0.83-1.02, P = 0.12;I2 = 68%)。然而，对实验室确认人群的亚组分析显示，就诊前使用OAC对死亡率有有益影响(HR = 0.84, 95% CI: 0.73-0.98, P = 0.02;I2 = 56%)。结论:就诊前使用OAC对COVID-19患者全因死亡率无显著影响。
The effect of oral anticoagulant use before visit for patients with COVID-19 on mortality: A meta-analysis.
Objectives: Anticoagulants have been used as therapeutic or prophylactic agents in COVID-19 and seem to be more beneficial. However, the advantage of oral anticoagulant (OAC) consumption before visit in lowering mortality in COVID-19 patients remains debatable. This meta-analysis aimed to evaluate the effect of OAC use before visit on mortality using the hazard ratio (HR) to estimate the effect of time-to-event endpoints.
Materials and methods: We conducted a literature search in the PubMed and ProQuest databases for any studies comparing groups consuming OAC to no-OAC before visit for mortality in patients with COVID-19. We calculated the overall HRs and their variances across the studies using the random-effects model to obtain pooled estimates.
Results: We included 12 studies which had sample sizes ranging from 70 to 459,402 patients. A meta-analysis comparing OAC therapy and non-OAC consumption in COVID-19 patients before visit revealed no decrease in all-cause mortality (HR = 0.92, 95% confidence interval [CI]: 0.83-1.02, P = 0.12; I2 = 68%). However, subgroup analysis of laboratory-confirmed populations revealed that OAC use before visit had a beneficial effect on mortality (HR = 0.84, 95% CI: 0.73-0.98, P = 0.02; I2 = 56%).
Conclusion: The use of OAC before visit had no beneficial effect on all-cause mortality in COVID-19 patients.
期刊介绍：
The Tzu Chi Medical Journal is the peer-reviewed publication of the Buddhist Compassion Relief Tzu Chi Foundation, and includes original research papers on clinical medicine and basic science, case reports, clinical pathological pages, and review articles.
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