Profile of parenteral anticoagulant use in patients with COVID-19 in an university hospital in Rio de Janeiro
Objective: To evaluate the anticoagulation prescription in the hospitalized COVID-19 patients, and the occurrence of hemorrhagic events, in those with anticoagulation usage, that developed acute respiratory distress syndrome (ARDS), requiring advanced medical support at the ICU, compared with hospitalized patients with non-requirement of advanced medical support. Methods: Observational descriptive study with a quantitative approach, developed at a public hospital in Rio de Janeiro city, between March 29 to October 13 of 2020. Data was analyzed and collected from the electronic clinical record from hospitalized patients with a COVID-19 diagnosis, confirmed by RT-PCR and with a minimal anticoagulation usage of 60% during the hospitalization period. The patients that met the inclusion criteria were divided in 2 groups: Group 1, patients that developed ARDS, requiring advanced medical support at the ICU or any other unit. Group 2, patients that required hospitalization with no requirement of advance medical support. Results: From the 421 hospitalized patients with COVID-19, a total of 281 clinical record were analyzed, from which, 218 met the study’s inclusion criteria. From those, 112 (51%) were categorized within the Group 1, and 106(49%) in the Group 2. Mean general Age was 64 (p=0.053) and the majority where males (52%). The general mortality was 33.5%, where those in the group 1 were affected the most (60.7%). Regarding the anticoagulant usage, 160 patients (73.6%) used a prophylactic dosage, 47 patients (21.6%) used an intermediate dosage and 11 (5%) used a therapeutic dosage. In general, 27 patients (12.4%) had hemorrhagic events after the start the anticoagulation treatment. From those, 18 patients (66.7%) were use of prophylactic dosage, before the event, 5 patients (18.5%) were in intermediate, and 4 patients (14.8%) were in therapeutic dosage. Conclusion: In this study was possible to observe which dosage was the most used in hospitalized patients, in concordance with the literature evidence and with the own institution´s recommendations. The occurrence of hemorrhagic events was greater in the patients group who used the prophylactic dosage.
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