Scholarlink

Background <p>Individuals aged 80 and older face a notably increased risk of venous thromboembolism (VTE) and mortality after SARS-CoV-2 infection. Clinical guidelines recommend routine pharmacological thromboprophylaxis, yet its application in oldest-old patients remains insufficiently studied.</p> Aims <p>To assess the efficacy and safety of low-molecular-weight heparin (LMWH) thromboprophylaxis in hospitalized COVID-19 patients aged 80&#xa0;years and older.</p> Methods <p>We conducted a multicenter, prospective cohort study enrolling in-hospital COVID-19 patients aged ≥ 80&#xa0;years from six tertiary hospitals in China between December 2022 and January 2023. The clinical outcomes were VTE, all-cause mortality and bleeding events. Patients were followed up for 3&#xa0;months after discharge. Multivariate Cox regression models were used to identify risk factors and evaluate the impact of LMWH prophylaxis on clinical outcomes.</p> Results <p>Among 1526 patients aged ≥ 80&#xa0;years, 41.6% received LMWH prophylaxis. LMWH prophylaxis significantly reduced VTE risk by 50% (HR 0.50, 95% CI 0.33–0.75) and mortality risk by 20% (HR 0.80, 95% CI 0.65–0.99), without increasing bleeding risk (HR 0.90, 95% CI 0.60–1.34). Male, history of stroke, critical illness on admission and hemoglobin &lt; 90&#xa0;g/L were identified as risk factors of bleeding. LMWH prophylaxis remained effective in preventing VTE and demonstrated favorable safety particularly in male patients and patients with hemoglobin &lt; 90&#xa0;g/L.</p> Discussion and conclusion <p>LMWH may be safe and effective for thromboprophylaxis in the oldest-old COVID-19 patients, even in patients with high bleeding risk. Further studies are needed to verify our findings.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Impact of prophylactic anticoagulation on hospitalized COVID-19 patients aged over 80 years: a multicenter prospective cohort study

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年8月25日

查看全文
  • Feiya Xu,
  • Guohui Fan,
  • Jing Han,
  • Yuzhi Tao,
  • Lijun Chen,
  • Yunhui Zhang,
  • Binliang Wang,
  • Chaosheng Deng,
  • Weijia Liu,
  • Yunxia Zhang,
  • Zhu Zhang,
  • Shuai Zhang,
  • Yeming Wang,
  • Jun Wan,
  • Wanmu Xie,
  • Peiran Yang,
  • Wenbin Wu,
  • Dingyi Wang,
  • Chen Wang,
  • Zhenguo Zhai

摘要

Background

Individuals aged 80 and older face a notably increased risk of venous thromboembolism (VTE) and mortality after SARS-CoV-2 infection. Clinical guidelines recommend routine pharmacological thromboprophylaxis, yet its application in oldest-old patients remains insufficiently studied.

Aims

To assess the efficacy and safety of low-molecular-weight heparin (LMWH) thromboprophylaxis in hospitalized COVID-19 patients aged 80 years and older.

Methods

We conducted a multicenter, prospective cohort study enrolling in-hospital COVID-19 patients aged ≥ 80 years from six tertiary hospitals in China between December 2022 and January 2023. The clinical outcomes were VTE, all-cause mortality and bleeding events. Patients were followed up for 3 months after discharge. Multivariate Cox regression models were used to identify risk factors and evaluate the impact of LMWH prophylaxis on clinical outcomes.

Results

Among 1526 patients aged ≥ 80 years, 41.6% received LMWH prophylaxis. LMWH prophylaxis significantly reduced VTE risk by 50% (HR 0.50, 95% CI 0.33–0.75) and mortality risk by 20% (HR 0.80, 95% CI 0.65–0.99), without increasing bleeding risk (HR 0.90, 95% CI 0.60–1.34). Male, history of stroke, critical illness on admission and hemoglobin < 90 g/L were identified as risk factors of bleeding. LMWH prophylaxis remained effective in preventing VTE and demonstrated favorable safety particularly in male patients and patients with hemoglobin < 90 g/L.

Discussion and conclusion

LMWH may be safe and effective for thromboprophylaxis in the oldest-old COVID-19 patients, even in patients with high bleeding risk. Further studies are needed to verify our findings.