Chronic therapeutic anticoagulation is associated with decreased thrombotic complications in SARS‐CoV‐2 infection

BACKGROUND: Thrombotic disease complicates severe SARS‐CoV‐2 infection and is associated with increased morbidity and mortality. Various anticoagulation strategies have been evaluated in hospitalized patients to prevent complications. The impact of chronic anticoagulation before SARS‐CoV‐2 infection on the risk for subsequent thrombosis has not been systematically studied. METHODS: This was a retrospective single‐center study. All patients with positive SARS‐CoV‐2 PCR testing from March 13, 2020, through May 6, 2020, at the University of Rochester Medical Center were identified. We included all patients receiving therapeutic anticoagulation for at least 1 month before COVID diagnosis. We documented the rate of thrombotic complications, type of anticoagulation, bleeding complications, and mortality. RESULTS: A total of 107 SARS‐CoV2‐infected patients were chronically anticoagulated before SARS‐CoV‐2 testing with a median age of 78. Of those, 42 required hospital admission, with 17 requiring intensive care. No patients, inpatient or outpatient, were diagnosed with a new symptomatic thrombotic complication. Three patients had minor bleeding in the hospital. Thirteen (12%) patients died (69% male). CONCLUSION: Our uncontrolled findings suggest that chronic anticoagulation at the time of infection may protect against thrombotic complications and decrease disease severity.