Cargando…

Regular Use of VKA Prior to COVID-19 Associated with Lower 7-Day Survival in Hospitalized Frail Elderly COVID-19 Patients: The GERIA-COVID Cohort Study

Background. Vitamin K concentrations are inversely associated with the clinical severity of COVID-19. The objective of this cohort study was to determine whether the regular use of vitamin K antagonist (VKA) prior to COVID-19 was associated with short-term mortality in frail older adults hospitalize...

Descripción completa

Detalles Bibliográficos
Autores principales: Ménager, Pierre, Brière, Olivier, Gautier, Jennifer, Riou, Jérémie, Sacco, Guillaume, Brangier, Antoine, Annweiler, Cédric
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7824717/
https://www.ncbi.nlm.nih.gov/pubmed/33374341
http://dx.doi.org/10.3390/nu13010039
_version_ 1783640146223038464
author Ménager, Pierre
Brière, Olivier
Gautier, Jennifer
Riou, Jérémie
Sacco, Guillaume
Brangier, Antoine
Annweiler, Cédric
author_facet Ménager, Pierre
Brière, Olivier
Gautier, Jennifer
Riou, Jérémie
Sacco, Guillaume
Brangier, Antoine
Annweiler, Cédric
author_sort Ménager, Pierre
collection PubMed
description Background. Vitamin K concentrations are inversely associated with the clinical severity of COVID-19. The objective of this cohort study was to determine whether the regular use of vitamin K antagonist (VKA) prior to COVID-19 was associated with short-term mortality in frail older adults hospitalized for COVID-19. Methods. Eighty-two patients consecutively hospitalized for COVID-19 in a geriatric acute care unit were included. The association of the regular use of VKA prior to COVID-19 with survival after 7 days of COVID-19 was examined using a propensity-score-weighted Cox proportional-hazards model accounting for age, sex, severe undernutrition, diabetes mellitus, hypertension, prior myocardial infarction, congestive heart failure, prior stroke and/or transient ischemic attack, CHA2DS2-VASc score, HAS-BLED score, and eGFR. Results. Among 82 patients (mean ± SD age 88.8 ± 4.5 years; 48% women), 73 survived COVID-19 at day 7 while 9 died. There was no between-group difference at baseline, despite a trend for more frequent use of VKA in those who did not survive on day 7 (33.3% versus 8.2%, p = 0.056). While considering “using no VKA” as the reference (hazard ratio (HR) = 1), the HR for 7-day mortality in those regularly using VKA was 5.68 [95% CI: 1.17; 27.53]. Consistently, COVID-19 patients using VKA on a regular basis had shorter survival times than the others (p = 0.031). Conclusions. Regular use of VKA was associated with increased mortality at day 7 in hospitalized frail elderly patients with COVID-19.
format Online
Article
Text
id pubmed-7824717
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-78247172021-01-24 Regular Use of VKA Prior to COVID-19 Associated with Lower 7-Day Survival in Hospitalized Frail Elderly COVID-19 Patients: The GERIA-COVID Cohort Study Ménager, Pierre Brière, Olivier Gautier, Jennifer Riou, Jérémie Sacco, Guillaume Brangier, Antoine Annweiler, Cédric Nutrients Article Background. Vitamin K concentrations are inversely associated with the clinical severity of COVID-19. The objective of this cohort study was to determine whether the regular use of vitamin K antagonist (VKA) prior to COVID-19 was associated with short-term mortality in frail older adults hospitalized for COVID-19. Methods. Eighty-two patients consecutively hospitalized for COVID-19 in a geriatric acute care unit were included. The association of the regular use of VKA prior to COVID-19 with survival after 7 days of COVID-19 was examined using a propensity-score-weighted Cox proportional-hazards model accounting for age, sex, severe undernutrition, diabetes mellitus, hypertension, prior myocardial infarction, congestive heart failure, prior stroke and/or transient ischemic attack, CHA2DS2-VASc score, HAS-BLED score, and eGFR. Results. Among 82 patients (mean ± SD age 88.8 ± 4.5 years; 48% women), 73 survived COVID-19 at day 7 while 9 died. There was no between-group difference at baseline, despite a trend for more frequent use of VKA in those who did not survive on day 7 (33.3% versus 8.2%, p = 0.056). While considering “using no VKA” as the reference (hazard ratio (HR) = 1), the HR for 7-day mortality in those regularly using VKA was 5.68 [95% CI: 1.17; 27.53]. Consistently, COVID-19 patients using VKA on a regular basis had shorter survival times than the others (p = 0.031). Conclusions. Regular use of VKA was associated with increased mortality at day 7 in hospitalized frail elderly patients with COVID-19. MDPI 2020-12-24 /pmc/articles/PMC7824717/ /pubmed/33374341 http://dx.doi.org/10.3390/nu13010039 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ménager, Pierre
Brière, Olivier
Gautier, Jennifer
Riou, Jérémie
Sacco, Guillaume
Brangier, Antoine
Annweiler, Cédric
Regular Use of VKA Prior to COVID-19 Associated with Lower 7-Day Survival in Hospitalized Frail Elderly COVID-19 Patients: The GERIA-COVID Cohort Study
title Regular Use of VKA Prior to COVID-19 Associated with Lower 7-Day Survival in Hospitalized Frail Elderly COVID-19 Patients: The GERIA-COVID Cohort Study
title_full Regular Use of VKA Prior to COVID-19 Associated with Lower 7-Day Survival in Hospitalized Frail Elderly COVID-19 Patients: The GERIA-COVID Cohort Study
title_fullStr Regular Use of VKA Prior to COVID-19 Associated with Lower 7-Day Survival in Hospitalized Frail Elderly COVID-19 Patients: The GERIA-COVID Cohort Study
title_full_unstemmed Regular Use of VKA Prior to COVID-19 Associated with Lower 7-Day Survival in Hospitalized Frail Elderly COVID-19 Patients: The GERIA-COVID Cohort Study
title_short Regular Use of VKA Prior to COVID-19 Associated with Lower 7-Day Survival in Hospitalized Frail Elderly COVID-19 Patients: The GERIA-COVID Cohort Study
title_sort regular use of vka prior to covid-19 associated with lower 7-day survival in hospitalized frail elderly covid-19 patients: the geria-covid cohort study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7824717/
https://www.ncbi.nlm.nih.gov/pubmed/33374341
http://dx.doi.org/10.3390/nu13010039
work_keys_str_mv AT menagerpierre regularuseofvkapriortocovid19associatedwithlower7daysurvivalinhospitalizedfrailelderlycovid19patientsthegeriacovidcohortstudy
AT briereolivier regularuseofvkapriortocovid19associatedwithlower7daysurvivalinhospitalizedfrailelderlycovid19patientsthegeriacovidcohortstudy
AT gautierjennifer regularuseofvkapriortocovid19associatedwithlower7daysurvivalinhospitalizedfrailelderlycovid19patientsthegeriacovidcohortstudy
AT rioujeremie regularuseofvkapriortocovid19associatedwithlower7daysurvivalinhospitalizedfrailelderlycovid19patientsthegeriacovidcohortstudy
AT saccoguillaume regularuseofvkapriortocovid19associatedwithlower7daysurvivalinhospitalizedfrailelderlycovid19patientsthegeriacovidcohortstudy
AT brangierantoine regularuseofvkapriortocovid19associatedwithlower7daysurvivalinhospitalizedfrailelderlycovid19patientsthegeriacovidcohortstudy
AT annweilercedric regularuseofvkapriortocovid19associatedwithlower7daysurvivalinhospitalizedfrailelderlycovid19patientsthegeriacovidcohortstudy
AT regularuseofvkapriortocovid19associatedwithlower7daysurvivalinhospitalizedfrailelderlycovid19patientsthegeriacovidcohortstudy