Mortality, critical illness, and mechanical ventilation among hospitalized patients with COVID-19 on therapeutic anticoagulants

  1. Niti G. Patel
  2. Ajay Bhasin
  3. Joseph M. Feinglass
  4. Michael P. Angarone
  5. Elaine R. Cohen
  6. Jeffrey H. Barsuk

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Abstract

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  1. ScreenIT

    SciScore for 10.1101/2020.08.22.20179911: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: The Northwestern University Institutional Review Board approved this study (Approval Reference STU00212532).
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Our study has several limitations. First, our-cohort definition and clinical data relied on the accuracy of ICD-10 coding for disease diagnoses, although we did manually review 372 (22%) charts which confirmed COVID-19 infection and assessed timing and indication for therapeutic anticoagulation. Second, our study was observational, and despite attempting to control for confounding clinical variables, there may have been unidentified confounding factors. Third, we did not evaluate outcomes by individual anticoagulant drug. It is possible that the clinical effects of DOACs and LMWH differ in patients with COVID-19 (27,43). Finally, we did not control for the number of days subjects received new therapeutic anticoagulation because we were unable to determine the timing of starting these medications within the course of COVID-19 infection. In conclusion, continuation of home therapeutic anticoagulation was associated with neither benefit nor harm in subjects hospitalized with COVID-19. Subjects with COVID-19 who had not previously been anticoagulated and who were empirically prescribed therapeutic anticoagulation during their hospitalization had worse outcomes. Our findings do not support routine use of therapeutic anticoagulation for patients with COVID-19 infection in the absence of other indications (i.e., atrial fibrillation or venous thromboembolism) until randomized controlled trials provide further evidence.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1016/j.tru.2020.100027
  3. Version published to 10.1101/2020.08.22.20179911v1 on medRxiv