PMID- 37872904
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231026
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 15
IP  - 9
DP  - 2023 Sep
TI  - The Role of Anticoagulants and Antiplatelets in Reducing Mortality in COVID-19 
      Patients: A Systematic Review and Meta-Analysis of Studies Reporting Adjusted 
      Data.
PG  - e45749
LID - 10.7759/cureus.45749 [doi]
LID - e45749
AB  - The coronavirus disease 2019 (COVID-19) is associated with prolonged prothrombin 
      time (PT), active partial thromboplastin time (aPTT), and increased D-dimer 
      levels. Therefore, we aim to investigate if anticoagulants (AC) and antiplatelet 
      (AP) therapy play a role in mitigating COVID-19 and its associated thrombosis 
      along with its effect on the mortality rate, the need for mechanical ventilation, 
      and the risk of hospital admission. Electronic databases were searched from their 
      inception to July 19, 2022. The studies were divided into two groups: Group A 
      (any dose of AC/AP versus no AC/AP) and Group B (therapeutic dose of AC (tAC)/AP 
      versus prophylactic dose of AC (pAC)/AP). Review Manager (RevMan) version 5.4.1 
      (The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, Denmark) was 
      used for all statistical analyses. Adjusted data ratios were extracted from all 
      included studies and pooled using the random effects model. A total of 33 studies 
      were taken for the analysis of two groups (Group A: 285,065 COVID-19-positive 
      patients, Group B: 2,421 COVID-19-positive patients). Overall analysis in Group A 
      showed that the AC/AP group had a low risk of mortality in COVID-19 patients 
      compared to the control group (risk ratio (RR): 0.77, 95% confidence interval 
      (CI): 0.69-0.86). There was no significant difference in the need for mechanical 
      ventilation (RR: 0.80, 95% CI: 0.60-1.08) and hospital admission (RR: 1.12, 95% 
      CI: 0.78-1.59) between the AC/AP and no AC/AP group. Alongside, in Group B, 
      tAC/AP did not demonstrate a significant decrease in mortality as compared to 
      pAC/AP (RR: 0.62, 95% CI: 0.37-1.06). Treatment with AC and AP drugs can 
      significantly decrease the mortality rate in COVID-19-infected patients, while AC 
      also significantly reduces the need for mechanical ventilation.
CI  - Copyright (c) 2023, Ram et al.
FAU - Ram, Muskaan Doulat
AU  - Ram MD
AD  - Internal Medicine, Dow University of Health Sciences, Karachi, PAK.
FAU - Umer, Muhammed
AU  - Umer M
AD  - Internal Medicine, Dow University of Health Sciences, Karachi, PAK.
FAU - Trada, Ishani Jayantibhai
AU  - Trada IJ
AD  - Internal Medicine, American University of Barbados, Bridgetown, BRB.
FAU - Khan, Salman J
AU  - Khan SJ
AD  - Internal Medicine, Mayo Clinic, Jacksonville, USA.
FAU - Imran, Laiba
AU  - Imran L
AD  - Internal Medicine, Dow University of Health Sciences, Karachi, PAK.
FAU - Rehan, Tayyaba
AU  - Rehan T
AD  - Internal Medicine, Dow University of Health Sciences, Karachi, PAK.
FAU - Hassan, Warda
AU  - Hassan W
AD  - Internal Medicine, Dow University of Health Sciences, Karachi, PAK.
FAU - Zafar, Faiqa
AU  - Zafar F
AD  - General Surgery, New York Institute of Osteopathic Medicine, New York, USA.
FAU - Razak, Sufyan
AU  - Razak S
AD  - Oncology, Johns Hopkins University School of Medicine, Baltimore, USA.
AD  - Internal Medicine, Dow University of Health Sciences, Karachi, PAK.
FAU - Laeeq, Tooba
AU  - Laeeq T
AD  - Internal Medicine, Kirk Kerkorian School of Medicine at University of Nevada, Las 
      Vegas (UNLV), Las Vegas, USA.
FAU - Aijaz, Parisa
AU  - Aijaz P
AD  - Internal Medicine, Charleston Area Medical Center, Charleston, USA.
FAU - Majid, Zainab
AU  - Majid Z
AD  - Internal Medicine, Dow University of Health Sciences, Karachi, PAK.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20230922
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC10590480
OTO - NOTNLM
OT  - anticoagulants
OT  - antiplatelets
OT  - covid-19
OT  - mortality
OT  - severe acute respiratory syndrome
COIS- The authors have declared that no competing interests exist.
EDAT- 2023/10/24 06:41
MHDA- 2023/10/24 06:42
PMCR- 2023/09/22
CRDT- 2023/10/24 03:46
PHST- 2023/09/22 00:00 [accepted]
PHST- 2023/10/24 06:42 [medline]
PHST- 2023/10/24 06:41 [pubmed]
PHST- 2023/10/24 03:46 [entrez]
PHST- 2023/09/22 00:00 [pmc-release]
AID - 10.7759/cureus.45749 [doi]
PST - epublish
SO  - Cureus. 2023 Sep 22;15(9):e45749. doi: 10.7759/cureus.45749. eCollection 2023 
      Sep.