TY - JOUR
AU - Wong, Angel Y.S.
AU - Tomlinson, Laurie
AU - Brown, Jeremy P.
AU - Elson, William
AU - Walker, Alex J.
AU - Schultze, Anna
AU - Morton, Caroline E.
AU - Evans, David
AU - Inglesby, Peter
AU - Mackenna, Brian
AU - Bhaskaran, Krishnan
AU - Rentsch, Christopher T.
AU - Powell, Emma
AU - Williamson, Elizabeth
AU - Croker, Richard
AU - Bacon, Sebastian C.J.
AU - Hulme, William
AU - Bates, Chris J.
AU - Curtis, Helen J.
AU - Mehrkar, Amir
AU - Cockburn, Jonathan
AU - McDonald, Helen I.
AU - Mathur, Rohini
AU - Wing, Kevin
AU - Forbes, Harriet
AU - Eggo, Rosalind M.
AU - Evans, Stephen J.W.
AU - Smeeth, Liam
AU - Goldacre, Ben
AU - Douglas, Ian J.
AU - The OpenSAFELY Collaborative
PY - 2022
DA - June
TI - Association between oral anticoagulants and COVID-19-related outcomes: a population-based cohort study
JO - British Journal of General Practice
EP - e463
VL - 72
IS - 720
DO - https://doi.org/10.3399/BJGP.2021.0689
AB - Background Early evidence has shown that anticoagulant reduces the risk of thrombotic events in those infected with COVID-19. However, evidence of the role of routinely prescribed oral anticoagulants (OACs) in COVID-19 outcomes is limited. Aim To investigate the association between OACs and COVID-19 outcomes in those with atrial fibrillation and a CHA2DS2-VASc score of 2. Design and setting On behalf of NHS England, a population-based cohort study was conducted. Method The study used primary care data and pseudonymously-linked SARS-CoV-2 antigen testing data, hospital admissions, and death records from England. Cox regression was used to estimate hazard ratios (HRs) for COVID-19 outcomes comparing people with current OAC use versus non-use, accounting for age, sex, comorbidities, other medications, deprivation, and general practice. Results Of 71 103 people with atrial fibrillation and a CHA2DS2-VASc score of 2, there were 52 832 current OAC users and 18 271 non-users. No difference in risk of being tested for SARS-CoV-2 was associated with current use (adjusted HR [aHR] 0.99, 95% confidence interval [CI] = 0.95 to 1.04) versus non-use. A lower risk of testing positive for SARS-CoV-2 (aHR 0.77, 95% CI = 0.63 to 0.95) and a marginally lower risk of COVID-19- related death (aHR, 0.74, 95% CI = 0.53 to 1.04) were associated with current use versus non-use. Conclusion Among those at low baseline stroke risk, people receiving OACs had a lower risk of testing positive for SARS-CoV-2 and severe COVID-19 outcomes than non-users; this might be explained by a causal effect of OACs in preventing severe COVID-19 outcomes or unmeasured confounding, including more cautious behaviours leading to reduced infection risk.
PB - Royal College of General Practitioners
UR - https://www.research.ed.ac.uk/en/publications/525f9f83-79e5-4814-81b5-09d2a6325c37
KW - Coronavirus (COVID-19)
ER