Chronic anticoagulation is not associated with a reduced risk of acute kidney injury in hospitalised Covid-19 patients

Parker, Kathrine; Hamilton, Patrick; Hanumapura, Prasanna; Castelino, Laveena Riya; Murphy, Michelle; Challiner, Rachael; Thachil, Jecko; Ebah, Leonard

doi:10.1186/s12882-021-02436-5

Cited by 9 publications

(10 citation statements)

References 41 publications

(63 reference statements)

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“…Foram selecionados 46 estudos para a leitura exploratória e realizado a seleção de 44 artigos para a amostra final, pois atendiam aos critérios de elegibilidade conforme fluxograma (Figura 1). Todos os estudos incluídos foram publicados em língua inglesa, entre 2020 e 2022, desenvolvidos na América do Sul (16)(17)(18)(19) e América do Norte, (20)(21)(22)(23)(24)(25)(26)(27) Ásia, (28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42) Europa, (43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53) África (54) e Oriente Médio. (55)(56)(57)(58) O país com maior número de publicações sobre LRA associada à COVID-19 foi a China, contemplando 27,3% (n = 12) dos artigos.…”

Section: Resultsunclassified

Lesão renal aguda em pacientes adultos com COVID-19: revisão integrativa

Pereira,

Almeida,

Aguiar

et al. 2024

Acta Paulista De Enfermagem

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intitulado "Fatores associados ao desenvolvimento da lesão renal aguda em pacientes adultos com COVID-19: revisão integrativa". ResumoObjetivo: Identificar a frequência de lesão renal aguda (LRA) em pacientes hospitalizados com COVID-19, as características associadas, a mortalidade e a letalidade.Métodos: Revisão realizada nas bases de dados CINAHL, Embase, LILACS, Livivo, PubMed, SCOPUS, Web of Science e, na literatura cinzenta (Google Acadêmico) em 12 de janeiro de 2022. Foram incluídos artigos em inglês, espanhol e português, publicados a partir de novembro 2019 até janeiro de 2022, em pacientes maiores de 18 anos com COVID-19 hospitalizados e LRA conforme critério Kidney Disease Improving Global Outcomes (KDIGO). Os estudos selecionados foram lidos na íntegra para extração, interpretação, síntese e categorização conforme nível de evidência.Resultados: 699 artigos encontrados e 45 incluídos. A idade avançada, sexo masculino, hipertensão, doença renal crônica, ventilação mecânica, aumento da proteína C reativa, uso de drogas vasoativas e de determinadas classes de anti-hipertensivos foram associados a LRA. A LRA está relacionada à maior frequência de mortalidade. Em 30% dos pacientes hospitalizados com COVID-19 houve LRA. A taxa de mortalidade por LRA foi de 5% e a letalidade de 18%.Conclusão: Estes resultados ressaltam a relevância da LRA como uma complicação significativa da COVID-19 e sugerem que um controle mais cuidadoso e precoce dos fatores associados poderia potencialmente reduzir a mortalidade e a letalidade. É crucial intensificar a pesquisa nesse campo para esclarecer melhor os mecanismos envolvidos na lesão renal em pacientes com COVID-19, bem como identificar estratégias terapêuticas mais efetivas para sua prevenção e tratamento nesse contexto.

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Section: Resultsunclassified

Lesão renal aguda em pacientes adultos com COVID-19: revisão integrativa

Pereira,

Almeida,

Aguiar

et al. 2024

Acta Paulista De Enfermagem

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“…In addition, Paranjpe et al showed longer duration of AC treatment reduced the risk of in-hospital mortality (aHR of 0.86 per day; 95% CI: 0.82 – 0.89; p < 0.001) [ 38 ]. On the other hand, AC was not shown to reduce the incidence or severity of MSOC such as acute kidney injury [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, the data regarding the role of chronic anticoagulation in outcomes of COVID-19 has since remained conflicting. Parker et al reported reduced rates of mechanical ventilation (8.5% vs 17.4%) in chronically anticoagulated patients with COVID-19 but a higher (40.2% vs 30%) mortality rate [ 13 ]. On the other hand, Tremblay et al demonstrated no mortality benefit in a propensity matched cohort of 241 patients receiving anticoagulation prior to COVID-19 infection [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Chronic anti-coagulation therapy reduced mortality in patients with high cardiovascular risk early in COVID-19 pandemic

et al. 2023

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Background Coronavirus disease 2019 (COVID-19) is associated with provoked thrombo-inflammatory responses. Early in the COVID-19 pandemic this was thought to contribute to hypercoagulability and multi-organ system complications in infected patients. Limited studies have evaluated the impact of therapeutic anti-coagulation therapy (AC) in alleviating these risks in COVID-19 positive patients. Our study aimed to investigate whether long-term therapeutic AC can decrease the risk of multi-organ system complications (MOSC) including stroke, limb ischemia, gastrointestinal (GI) bleeding, in-hospital and intensive care unit death in COVID-19 positive patients hospitalized during the early phase of the pandemic in the United States. Methods A retrospective analysis was conducted of all COVID-19 positive United States Veterans between March 2020 and October 2020. Patients receiving continuous outpatient therapeutic AC for a least 90 days prior to their initial COVID-19 positive test were assigned to the AC group. Patients who did not receive AC were included in a control group. We analyzed the primary study outcome of MOSC between the AC and control groups using binary logistic regression analysis (Odd-Ratio; OR). Results We identified 48,066 COVID-19 patients, of them 879 (1.8%) were receiving continuous therapeutic AC. The AC cohort had significantly worse comorbidities than the control group. On the adjusted binary logistic regression model, therapeutic AC significantly decreased in-hospital mortality rate (OR; 0.67, p = 0.04), despite a higher incidence of GI bleeding (OR; 4.00, p = 0.02). However, therapeutic AC did not significantly reduce other adverse events. Conclusion AC therapy reduced in-hospital death early in the COVID-19 pandemic among patients who were hospitalized with the infection. However, it did not decrease the risk of MOSC. Additional trials are needed to determine the effectiveness of AC in preventing complications associated with ongoing emerging strains of the COVID-19 virus.

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“…Moreover, hypertension is a recognized risk factor for renal function impairment and AKI in COVID-19 and the most common comorbidity in our study, which is supported by the literature. 24 - 26 Parker et al, 25 who aimed to investigate a possible effect of continuous anticoagulant therapy before hospitalization on the prevention of AKI, found the risk factors for AKI to be CKD, hypertension, and male sex. Our study went further and showed preexisting hypertension to be a risk factor for not only CA-AKI but also HA-AKI.…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcome and Risk Assessment in Hospitalized COVID-19 Patients with Elevated Transaminases and Acute Kidney Injury: A Single Center Study

Khruleva¹,

Kobalava²,

Arisheva³

et al. 2022

Oman Med J

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Objectives: Initial reports indicate a high incidence of abnormal aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels in patients with COVID-19 and possible association with acute kidney injury (AKI). We aimed to investigate clinical features of elevated transaminases on admission, its association with AKI, and outcomes in patients with COVID-19. Methods: A retrospective analysis of the registered data of hospitalized patients with laboratory-confirmed COVID-19 and assessment of the AST and ALT was performed. Multinomial logistic regression was used to determine factors associated with community-acquired AKI (CA-AKI) and hospital-acquired AKI (HA-AKI). Results: The subjects comprised 828 patients (mean age = 65.0±16.0 years; 51.4% male). Hypertension was present in 70.3% of patients, diabetes mellitus in 26.0%, and chronic kidney disease in 8.5%. In-hospital mortality was 21.0%. At admission, only 41.5% of patients had hypertransaminasemia. Patients with elevated transaminases at admission were younger, had higher levels of inflammatory markers and D-dimer, and poorer outcomes. The AKI incidence in the study population was 27.1%. Patients with hypertransaminasemia were more likely to develop AKI (33.5% vs. 23.3%, p =0.003). Patients with predominantly elevated AST (compared to elevated ALT) were more likely to have adverse outcomes. Multinomial logistic regression found that hypertension, chronic kidney disease, elevated AST, and hematuria were associated with CA-AKI. Meanwhile, age > 65 years, hypertension, malignancy, elevated AST, and hematuria were predictors of HA-AKI. Conclusions: Elevated transaminases on admission were associated with AKI and poor outcomes. Patients with elevated AST were more likely to have adverse outcomes. Elevated AST on admission was associated with CA-AKI and was a predictor of HA-AKI.

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Chronic anticoagulation is not associated with a reduced risk of acute kidney injury in hospitalised Covid-19 patients

Cited by 9 publications

References 41 publications

Lesão renal aguda em pacientes adultos com COVID-19: revisão integrativa

Lesão renal aguda em pacientes adultos com COVID-19: revisão integrativa

Chronic anti-coagulation therapy reduced mortality in patients with high cardiovascular risk early in COVID-19 pandemic

Clinical Outcome and Risk Assessment in Hospitalized COVID-19 Patients with Elevated Transaminases and Acute Kidney Injury: A Single Center Study

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