The prothrombotic state is a common abnormality in patients with coronavirus disease 2019 (COVID-19). However, there is controversy over the use of anticoagulants, especially oral anticoagulants (OAC) due to limited studies. We sought to evaluate the association between antithrombotic therapy on mortality and clinical outcomes in patients hospitalized for COVID-19 through propensity score matching (PSM) analysis. A retrospective cohort study was performed to include adult patients with COVID-19 in a university hospital. The primary outcome was in-hospital mortality. Secondary outcomes included intensive care unit (ICU) admission, mechanical ventilation, and acute kidney injury (AKI) during hospitalization. PSM was used as a powerful tool for matching patients’ baseline characteristics. Adjusted odds ratios (aOR) with 95% confidence intervals (CI) were calculated from the models. Of 4,881 COVID-19 patients during the study period, 690 (14.1%) patients received antithrombotic therapy and 4,191 (85.9%) patients were under no antithrombotic therapy. After adjustment with multivariate regression analysis, patients receiving OAC, compared with those who did not receive any antithrombotic therapy, had significantly lower odds for in-hospital mortality (aOR: 0.46. 95% CI: 0.24 to 0.87; P= 0.017). PSM analysis observed similar results (aOR: 0.35. 95% CI: 0.19 to 0.61; P< 0.001). Moreover, in critically ill patients who received mechanical ventilation, antithrombotic treatment (aOR: 0.54. 95% CI: 0.32 to 0.89; P= 0.022) was associated with reduced risk of mortality. The application OACs was associated with reduced hospital mortality and mechanical ventilation requirement in COVID-19 patients. Besides, antithrombotic treatment was associated with a reduction in in-hospital mortality among critically ill COVID-19 patients who required mechanical ventilation.

中文翻译：

---

因 COVID-19 住院患者的抗血栓治疗与死亡率之间的关联

血栓前状态是 2019 年冠状病毒病 (COVID-19) 患者的常见异常。然而，由于研究有限，抗凝剂特别是口服抗凝剂（OAC）的使用存在争议。我们试图通过倾向评分匹配（PSM）分析来评估抗血栓治疗对因 COVID-19 住院的患者的死亡率和临床结果之间的关联。一项回顾性队列研究纳入了大学医院的 COVID-19 成年患者。主要结局是院内死亡率。次要结局包括入住重症监护病房（ICU）、机械通气和住院期间的急性肾损伤（AKI）。PSM 被用作匹配患者基线特征的强大工具。根据模型计算出具有 95% 置信区间 (CI) 的调整优势比 (aOR)。研究期间，在 4,881 名 COVID-19 患者中，690 名（14.1%）名患者接受了抗血栓治疗，4,191 名（85.9%）名患者未接受抗血栓治疗。经过多变量回归分析调整后，与未接受任何抗血栓治疗的患者相比，接受 OAC 的患者院内死亡率显着降低（aOR：0.46。95% CI：0.24 至 0.87；P = 0.017）。PSM 分析观察到类似的结果（aOR：0.35。95% CI：0.19 至 0.61；P<0.001）。此外，在接受机械通气的危重患者中，抗血栓治疗（aOR：0.54。95% CI：0.32至0.89；P = 0.022）与死亡风险降低相关。OAC 的应用与降低 COVID-19 患者的医院死亡率和机械通气需求相关。此外，抗血栓治疗与需要机械通气的重症 COVID-19 患者的院内死亡率降低相关。