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oai:recercat.cat:11351/99492025-10-24T10:21:18Zcom_2072_378070com_2072_378040col_2072_378092

Edoxaban Versus Low-Molecular-Weight Heparin in Hospitalized COVID-19 Patients With Atrial Fibrillation Olivera, Pável E. Velásquez-Orozco, Fernando Campoy, Desirée Flores, Katia Canals, Tania Johansson, Erik Institut Català de la Salut [Olivera P, Campoy D] Unitat d’Hemostàsia i Trombosi, Servei d’Hematologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Velásquez-Escandón C] Department of Hematology, Fundación Sanitària Mollet, Barcelona, Spain. [Flores K, Johansson E] Department of Hematology, General University Hospital of Catalonia, Barcelona, Spain. [Canals T] Department of Hematology, University Hospital Sant Joan de Reus, Tarragona, Spain Vall d'Hebron Barcelona Hospital Campus Anticoagulants (Medicina) - Ús terapèutic COVID-19 (Malaltia) Fibril·lació auricular - Tractament DISEASES::Cardiovascular Diseases::Heart Diseases::Arrhythmias, Cardiac::Atrial Fibrillation Other subheadings::Other subheadings::Other subheadings::/drug therapy DISEASES::Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections CHEMICALS AND DRUGS::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Hematologic Agents::Anticoagulants Other subheadings::Other subheadings::/therapeutic use ENFERMEDADES::enfermedades cardiovasculares::enfermedades cardíacas::arritmias cardíacas::fibrilación atrial Otros calificadores::Otros calificadores::Otros calificadores::/farmacoterapia ENFERMEDADES::virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus COMPUESTOS QUÍMICOS Y DROGAS::acciones y usos químicos::acciones farmacológicas::usos terapéuticos::fármacos hematológicos::anticoagulantes Otros calificadores::Otros calificadores::/uso terapéutico COVID-19; Atrial fibrillation; Edoxaban COVID-19; Fibrilación auricular; Edoxaban COVID-19; Fibril·lació auricular; Edoxaban Objective During the first wave of the SARS-CoV-2 pandemic, management of anticoagulation therapy in hospitalized patients with atrial fibrillation (AF) was simplified to low-molecular-weight heparin (LMWH) followed by oral anticoagulation, mainly owing to the risk of drug–drug interactions. However, not all oral anticoagulants carry the same risk. Methods Observational, retrospective, and multicenter study that consecutively included hospitalized patients with AF anticoagulated with LMWH followed by oral anticoagulation or edoxaban concomitantly with empirical COVID-19 therapy. Time-to-event (mortality, total bleeds, and admissions to ICU) curves, using an unadjusted Kaplan-Meier method and Cox regression model adjusted for potential confounders were constructed. Results A total of 232 patients were included (80.3 ± 7.7 years, 50.0% men, CHA2DS2-VASc 4.1 ± 1.4; HAS-BLED 2.6 ± 1.0). During hospitalization, patients were taking azithromycin (98.7%), hydroxychloroquine (89.7%), and ritonavir/lopinavir (81.5%). The mean length of hospital stay was 14.6 ± 7.2 days, and total follow-up was 31.6 ± 13.4 days; 12.9% of patients required admission to ICU, 18.5% died, and 9.9% had a bleeding complication (34.8% major bleeding). Length of hospital stay was longer in patients taking LMWH (16.0 ± 7.7 vs 13.3 ± 6.5 days; P = .005), but mortality and total bleeds were similar in patients treated with edoxaban and those treated with LMWH followed by oral anticoagulation. Conclusions Mortality rates, arterial and venous thromboembolic complications, and bleeds did not significantly differ between AF patients receiving anticoagulation therapy with edoxaban or LMWH followed by oral anticoagulation. However, the duration of hospitalization was significantly lower with edoxaban. Edoxaban had a similar therapeutic profile to LMWH followed by oral anticoagulation and may provide additional benefits. 2023-07-03T11:48:27Z 2023-07-03T11:48:27Z 2023 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Olivera P, Velásquez-Escandón C, Campoy D, Flores K, Canals T, Johansson E, et al. Edoxaban Versus Low-Molecular-Weight Heparin in Hospitalized COVID-19 Patients With Atrial Fibrillation. Clin Appl Thromb Hemost. 2023;29:1-16. 1938-2723 https://hdl.handle.net/11351/9949 10.1177/10760296231180865 37282505 001003786400001 http://hdl.handle.net/11351/9949 eng Clinical and Applied Thrombosis/Hemostasis;29 https://doi.org/10.1177/10760296231180865 Attribution-NonCommercial 4.0 International http://creativecommons.org/licenses/by-nc/4.0/ info:eu-repo/semantics/openAccess application/pdf SAGE Publications Scientia