Regular Use of VKA Prior to COVID-19 Associated with Lower 7-Day Survival in Hospitalized Frail Elderly COVID-19 Patients: The GERIA-COVID Cohort Study

Ménager, Pierre; Brière, Olivier; Gautier, Jennifer; Riou, Jérémie; Sacco, Guillaume; Brangier, Antoine; Annweiler, Cédric; group, on behalf of the GERIA-COVID study

doi:10.3390/nu13010039

Cited by 20 publications

(23 citation statements)

References 31 publications

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“…For example, a recent study concluded that prior use of therapeutic anticoagulation was not associated with improved survival in hospitalized COVID-19 patients [ 39 ]. Similarly, a small study found that regular VKA use in hospitalized frail older patients with COVID-19 was associated with increased mortality during the first week [ 40 ]. On the contrary, a retrospective study concluded that COVID-19 patients on OAC at the time of infection and throughout their disease course had significantly lower risk of all-cause mortality at 21 days [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of direct-acting oral anticoagulants compared to vitamin K antagonists in COVID-19 outpatients with cardiometabolic diseases

Rivera‐Caravaca

Harrison

Buckley

et al. 2021

Cardiovasc Diabetol

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Background It remains uncertain if prior use of oral anticoagulants (OACs) in COVID-19 outpatients with multimorbidity impacts prognosis, especially if cardiometabolic diseases are present. Clinical outcomes 30-days after COVID-19 diagnosis were compared between outpatients with cardiometabolic disease receiving vitamin K antagonist (VKA) or direct-acting OAC (DOAC) therapy at time of COVID-19 diagnosis. Methods A study was conducted using TriNetX, a global federated health research network. Adult outpatients with cardiometabolic disease (i.e. diabetes mellitus and any disease of the circulatory system) treated with VKAs or DOACs at time of COVID-19 diagnosis between 20-Jan-2020 and 15-Feb-2021 were included. Propensity score matching (PSM) was used to balance cohorts receiving VKAs and DOACs. The primary outcomes were all-cause mortality, intensive care unit (ICU) admission/mechanical ventilation (MV) necessity, intracranial haemorrhage (ICH)/gastrointestinal bleeding, and the composite of any arterial or venous thrombotic event(s) at 30-days after COVID-19 diagnosis. Results 2275 patients were included. After PSM, 1270 patients remained in the study (635 on VKAs; 635 on DOACs). VKA-treated patients had similar risks and 30-day event-free survival than patients on DOACs regarding all-cause mortality, ICU admission/MV necessity, and ICH/gastrointestinal bleeding. The risk of any arterial or venous thrombotic event was 43% higher in the VKA cohort (hazard ratio 1.43, 95% confidence interval 1.03–1.98; Log-Rank test p = 0.029). Conclusion In COVID-19 outpatients with cardiometabolic diseases, prior use of DOAC therapy compared to VKA therapy at the time of COVID-19 diagnosis demonstrated lower risk of arterial or venous thrombotic outcomes, without increasing the risk of bleeding.

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Section: Discussionmentioning

confidence: 99%

Efficacy and safety of direct-acting oral anticoagulants compared to vitamin K antagonists in COVID-19 outpatients with cardiometabolic diseases

Rivera‐Caravaca

Harrison

Buckley

et al. 2021

Cardiovasc Diabetol

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“…The increase observed in GAS6 underlines the importance of the vitamin K status in COVID-19. Interestingly, increased uncarboxylated matrix Gla protein has been detected in COVID-19 patients with poor outcomes [25], and regular use of oral antivitamin K anticoagulants prior to COVID-19 is associated with lower survival in elderly patients [26]. A poor vitamin K status could decrease the vitamin K-dependent actions of GAS6 and the anticoagulant PROS1, among other effects [27].…”

Section: Figure 5 Axl Inhibition Reduced Cytokine Production Upon Lps Challenge In Activated Human Macrophages (Thp-1 Cells)mentioning

confidence: 99%

Growth Arrest-Specific Factor 6 (GAS6) Is Increased in COVID-19 Patients and Predicts Clinical Outcome

et al. 2021

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Background: Growth arrest-specific factor 6 (GAS6) and the Tyro3, AXL, and MERTK (TAM) receptors counterbalance pro-inflammatory responses. AXL is a candidate receptor for SARS-CoV-2, particularly in the respiratory system, and the GAS6/AXL axis is targeted in current clinical trials against COVID-19. However, GAS6 and TAMs have not been evaluated in COVID-19 patients at emergency admission. Methods: Plasma GAS6, AXL, and MERTK were analyzed in 132 patients consecutively admitted to the emergency ward during the first peak of COVID-19. Results: GAS6 levels were higher in the SARS-CoV-2-positive patients, increasing progressively with the severity of the disease. Patients with initial GAS6 at the highest quartile had the worst outcome, with a 3-month survival of 65%, compared to a 90% survival for the rest. Soluble AXL exhibited higher plasma concentration in deceased patients, without significant differences in MERTK among SARS-CoV-2-positive groups. GAS6 mRNA was mainly expressed in alveolar cells and AXL in airway macrophages. Remarkably, THP-1 human macrophage differentiation neatly induces AXL, and its inhibition (bemcentinib) reduced cytokine production in human macrophages after LPS challenge. Conclusions: Plasma GAS6 and AXL levels reflect COVID-19 severity and could be early markers of disease prognosis, supporting a relevant role of the GAS6/AXL system in the immune response in COVID-19.

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“…The Role of Complementary and Alternative Medicines in the Treatment and Management... DOI: http://dx.doi.org/10.5772/intechopen.100422 that vitamin K antagonist regular use was correlated with augmented mortality in hospitalized elderly patients affected with COVID-19 [86].…”

Section: Nutritional Supplementsmentioning

confidence: 99%

The Role of Complementary and Alternative Medicines in the Treatment and Management of COVID-19

Saxena¹

2022

Complementary Therapies

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Interception of coronavirus disease 2019 (COVID-19) into our life and its rapid global expansion, humanity has succumbed to a vulnerable position. COVID-19 is proclaiming millions of lives, underscores the urgent need for more effective therapeutic interventions. This disease created catastrophe and developments of new drugs and vaccines take a long duration. Hence, scientists and medical society turned their heads towards different approaches of treatment, referred to as complementary and alternative medicine (CAM) for eradicating the deadly virus. Ayurveda, herbal medicines, nutritional supplements, naturopathy, and yoga are some of the CAMs which have emerged as a ray of hope in these times. The understanding of the COVID-19 pathogenesis and its impact on immunity will progress the effective management of this lethal infectious disease. The host immune response has an elementary function of defense against the majority of infectious diseases including COVID-19. This chapter focuses on the utilization of various CAMs (Ayurveda, yoga, herbs, phytochemicals and nutritional supplements) in COVID-19 treatment. An additional attempt has been made in this chapter on the potential of CAMs to assist in improving immunological reactions against infections and thus may be an efficient approach in the prevention and/or management of severe acute respiratory syndrome coronavirus 2 infections.

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Regular Use of VKA Prior to COVID-19 Associated with Lower 7-Day Survival in Hospitalized Frail Elderly COVID-19 Patients: The GERIA-COVID Cohort Study

Cited by 20 publications

References 31 publications

Efficacy and safety of direct-acting oral anticoagulants compared to vitamin K antagonists in COVID-19 outpatients with cardiometabolic diseases

Efficacy and safety of direct-acting oral anticoagulants compared to vitamin K antagonists in COVID-19 outpatients with cardiometabolic diseases

Growth Arrest-Specific Factor 6 (GAS6) Is Increased in COVID-19 Patients and Predicts Clinical Outcome

The Role of Complementary and Alternative Medicines in the Treatment and Management of COVID-19

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