National Trends in Anticoagulation Therapy for COVID-19 Hospitalized Adults in the United States: Analyses of the National COVID Cohort Collaborative

Eileen Lee; Benjamin Bates; Nathaniel Kuhrt; Kathleen M. Andersen; Aayush Visaria; Rachel Patel; Soko Setoguchi; Adam B. Wilcox; Adam M. Lee; Alexis Graves; Alfred (jerrod) Anzalone; Amin Manna; Amit Saha; Amy Olex; Andrea Zhou; Andrew E. Williams; Andrew Southerland; Andrew T. Girvin; Anita Walden; Anjali A. Sharathkumar; Benjamin Amor; Benjamin Bates; Brian Hendricks; Brijesh Patel; Caleb Alexander; Carolyn Bramante; Cavin Ward-Caviness; Charisse Madlock-Brown; Christine Suver; Christopher Chute; Christopher Dillon; Chunlei Wu; Clare Schmitt; Cliff Takemoto; Dan Housman; Davera Gabriel; David A. Eichmann; Diego Mazzotti; Don Brown; Eilis Boudreau; Elaine Hill; Elizabeth Zampino; Emily Carlson Marti; Emily R. Pfaff; Evan French; Farrukh M. Koraishy; Federico Mariona; Fred Prior; George Sokos; Greg Martin; Harold Lehmann; Heidi Spratt; Hemalkumar Mehta; Hongfang Liu; Hythem Sidky; J. W.Awori Hayanga; Jami Pincavitch; Jaylyn Clark; Jeremy Richard Harper; Jessica Islam; Jin Ge; Joel Gagnier; Joel H. Saltz; Joel Saltz; Johanna Loomba; John Buse; Jomol Mathew; Joni L. Rutter; Julie A. McMurry; Justin Guinney; Justin Starren; Karen Crowley; Katie Rebecca Bradwell; Kellie M. Walters; Ken Wilkins; Kenneth R. Gersing; Kenrick Dwain Cato; Kimberly Murray; Kristin Kostka; Lavance Northington; Lee Allan Pyles; Leonie Misquitta; Lesley Cottrell; Lili Portilla; Mariam Deacy; Mark M. Bissell; Marshall Clark; Mary Emmett; Mary Morrison Saltz; Matvey B. Palchuk; Melissa A. Haendel; Meredith Adams; Meredith Temple-O'Connor; Michael G. Kurilla; Michele Morris; Nabeel Qureshi; Nasia Safdar; Nicole Garbarini; Noha Sharafeldin; Ofer Sadan; Patricia A. Francis; Penny Wung Burgoon; Peter Robinson; Philip R.O. Payne; Rafael Fuentes; Randeep Jawa; Rebecca Erwin-Cohen; Rena Patel; Richard A. Moffitt; Richard L. Zhu; Rishi Kamaleswaran; Robert Hurley; Robert T. Miller; Saiju Pyarajan; Sam G. Michael; Samuel Bozzette; Sandeep Mallipattu; Satyanarayana Vedula; Scott Chapman; Shawn T. O'Neil; Soko Setoguchi; Stephanie S. Hong; Steve Johnson; Tellen D. Bennett; Tiffany Callahan; Umit Topaloglu; Usman Sheikh; Valery Gordon; Vignesh Subbian; Warren A. Kibbe; Wenndy Hernandez; Will Beasley; Will Cooper; William Hillegass; Xiaohan Tanner Zhang; G. Caleb Alexander; Christopher G. Chute; Richard A. Moffitt; Jasvinder Singh

doi:10.1093/infdis/jiad194

National Trends in Anticoagulation Therapy for COVID-19 Hospitalized Adults in the United States: Analyses of the National COVID Cohort Collaborative

Eileen Lee, Benjamin Bates, Nathaniel Kuhrt, Kathleen M. Andersen, Aayush Visaria, Rachel Patel, Soko Setoguchi, Adam B. Wilcox, Adam M. Lee, Alexis Graves, Alfred (jerrod) Anzalone, Amin Manna, Amit Saha, Amy Olex, Andrea Zhou, Andrew E. Williams, Andrew Southerland, Andrew T. Girvin, Anita Walden, Anjali A. SharathkumarBenjamin Amor, Benjamin Bates, Brian Hendricks, Brijesh Patel, Caleb Alexander, Carolyn Bramante, Cavin Ward-Caviness, Charisse Madlock-Brown, Christine Suver, Christopher Chute, Christopher Dillon, Chunlei Wu, Clare Schmitt, Cliff Takemoto, Dan Housman, Davera Gabriel, David A. Eichmann, Diego Mazzotti, Don Brown, Eilis Boudreau, Elaine Hill, Elizabeth Zampino, Emily Carlson Marti, Emily R. Pfaff, Evan French, Farrukh M. Koraishy, Federico Mariona, Fred Prior, George Sokos, Greg Martin, Harold Lehmann, Heidi Spratt, Hemalkumar Mehta, Hongfang Liu, Hythem Sidky, J. W.Awori Hayanga, Jami Pincavitch, Jaylyn Clark, Jeremy Richard Harper, Jessica Islam, Jin Ge, Joel Gagnier, Joel H. Saltz, Joel Saltz, Johanna Loomba, John Buse, Jomol Mathew, Joni L. Rutter, Julie A. McMurry, Justin Guinney, Justin Starren, Karen Crowley, Katie Rebecca Bradwell, Kellie M. Walters, Ken Wilkins, Kenneth R. Gersing, Kenrick Dwain Cato, Kimberly Murray, Kristin Kostka, Lavance Northington, Lee Allan Pyles, Leonie Misquitta, Lesley Cottrell, Lili Portilla, Mariam Deacy, Mark M. Bissell, Marshall Clark, Mary Emmett, Mary Morrison Saltz, Matvey B. Palchuk, Melissa A. Haendel, Meredith Adams, Meredith Temple-O'Connor, Michael G. Kurilla, Michele Morris, Nabeel Qureshi, Nasia Safdar, Nicole Garbarini, Noha Sharafeldin, Ofer Sadan, Patricia A. Francis, Penny Wung Burgoon, Peter Robinson, Philip R.O. Payne, Rafael Fuentes, Randeep Jawa, Rebecca Erwin-Cohen, Rena Patel, Richard A. Moffitt, Richard L. Zhu, Rishi Kamaleswaran, Robert Hurley, Robert T. Miller, Saiju Pyarajan, Sam G. Michael, Samuel Bozzette, Sandeep Mallipattu, Satyanarayana Vedula, Scott Chapman, Shawn T. O'Neil, Soko Setoguchi, Stephanie S. Hong, Steve Johnson, Tellen D. Bennett, Tiffany Callahan, Umit Topaloglu, Usman Sheikh, Valery Gordon, Vignesh Subbian, Warren A. Kibbe, Wenndy Hernandez, Will Beasley, Will Cooper, William Hillegass, Xiaohan Tanner Zhang, G. Caleb Alexander, Christopher G. Chute, Richard A. Moffitt, Jasvinder Singh

Neurology

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Anticoagulation (AC) utilization patterns and their predictors among hospitalized coronavirus disease 2019 (COVID-19) patients have not been well described. Methods: Using the National COVID Cohort Collaborative, we conducted a retrospective cohort study (2020-2022) to assess AC use patterns and identify factors associated with therapeutic AC employing modified Poisson regression. Results: Among 162 842 hospitalized COVID-19 patients, 64% received AC and 24% received therapeutic AC. Therapeutic AC use declined from 32% in 2020 to 12% in 2022, especially after December 2021. Therapeutic AC predictors included age (relative risk [RR], 1.02; 95% confidence interval [CI], 1.02-1.02 per year), male (RR, 1.29; 95% CI, 1.27-1.32), non-Hispanic black (RR, 1.16; 95% CI, 1.13-1.18), obesity (RR, 1.48; 95% CI, 1.43-1.52), increased length of stay (RR, 1.01; 95% CI, 1.01-1.01 per day), and invasive ventilation (RR, 1.64; 95% CI, 1.59-1.69). Vaccination (RR, 0.88; 95% CI, 84-.92) and higher Charlson Comorbidity Index (CCI) (RR, 0.98; 95% CI,. 97-.98) were associated with lower therapeutic AC. Conclusions: Overall, two-thirds of hospitalized COVID-19 patients received any AC and a quarter received therapeutic dosing. Therapeutic AC declined after introduction of the Omicron variant. Predictors of therapeutic AC included demographics, obesity, length of stay, invasive ventilation, CCI, and vaccination, suggesting AC decisions driven by clinical factors including COVID-19 severity, bleeding risks, and comorbidities.

Original language	English (US)
Pages (from-to)	895-906
Number of pages	12
Journal	Journal of Infectious Diseases
Volume	228
Issue number	7
DOIs	https://doi.org/10.1093/infdis/jiad194
State	Published - Oct 1 2023

Keywords

COVID-19
anticoagulation
hospitalization

ASJC Scopus subject areas

General Medicine

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10.1093/infdis/jiad194

Cite this

Lee, E., Bates, B., Kuhrt, N., Andersen, K. M., Visaria, A., Patel, R., Setoguchi, S., Wilcox, A. B., Lee, A. M., Graves, A., Anzalone, A., Manna, A., Saha, A., Olex, A., Zhou, A., Williams, A. E., Southerland, A., Girvin, A. T., Walden, A., ... Singh, J. (2023). National Trends in Anticoagulation Therapy for COVID-19 Hospitalized Adults in the United States: Analyses of the National COVID Cohort Collaborative. Journal of Infectious Diseases, 228(7), 895-906. https://doi.org/10.1093/infdis/jiad194

Lee, E, Bates, B, Kuhrt, N, Andersen, KM, Visaria, A, Patel, R, Setoguchi, S, Wilcox, AB, Lee, AM, Graves, A, Anzalone, A, Manna, A, Saha, A, Olex, A, Zhou, A, Williams, AE, Southerland, A, Girvin, AT, Walden, A, Sharathkumar, AA, Amor, B, Bates, B, Hendricks, B, Patel, B, Alexander, C, Bramante, C, Ward-Caviness, C, Madlock-Brown, C, Suver, C, Chute, C, Dillon, C, Wu, C, Schmitt, C, Takemoto, C, Housman, D, Gabriel, D, Eichmann, DA, Mazzotti, D, Brown, D, Boudreau, E, Hill, E, Zampino, E, Marti, EC, Pfaff, ER, French, E, Koraishy, FM, Mariona, F, Prior, F, Sokos, G, Martin, G, Lehmann, H, Spratt, H, Mehta, H, Liu, H, Sidky, H, Hayanga, JWA, Pincavitch, J, Clark, J, Harper, JR, Islam, J, Ge, J, Gagnier, J, Saltz, JH, Saltz, J, Loomba, J, Buse, J, Mathew, J, Rutter, JL, McMurry, JA, Guinney, J, Starren, J, Crowley, K, Bradwell, KR, Walters, KM, Wilkins, K, Gersing, KR, Cato, KD, Murray, K, Kostka, K, Northington, L, Pyles, LA, Misquitta, L, Cottrell, L, Portilla, L, Deacy, M, Bissell, MM, Clark, M, Emmett, M, Saltz, MM, Palchuk, MB, Haendel, MA, Adams, M, Temple-O'Connor, M, Kurilla, MG, Morris, M, Qureshi, N, Safdar, N, Garbarini, N, Sharafeldin, N, Sadan, O, Francis, PA, Burgoon, PW, Robinson, P, Payne, PRO, Fuentes, R, Jawa, R, Erwin-Cohen, R, Patel, R, Moffitt, RA, Zhu, RL, Kamaleswaran, R, Hurley, R, Miller, RT, Pyarajan, S, Michael, SG, Bozzette, S, Mallipattu, S, Vedula, S, Chapman, S, O'Neil, ST, Setoguchi, S, Hong, SS, Johnson, S, Bennett, TD, Callahan, T, Topaloglu, U, Sheikh, U, Gordon, V, Subbian, V, Kibbe, WA, Hernandez, W, Beasley, W, Cooper, W, Hillegass, W, Zhang, XT, Alexander, GC, Chute, CG, Moffitt, RA & Singh, J 2023, 'National Trends in Anticoagulation Therapy for COVID-19 Hospitalized Adults in the United States: Analyses of the National COVID Cohort Collaborative', Journal of Infectious Diseases, vol. 228, no. 7, pp. 895-906. https://doi.org/10.1093/infdis/jiad194

@article{bff7da75e2064479a0cce71bdb19e733,

title = "National Trends in Anticoagulation Therapy for COVID-19 Hospitalized Adults in the United States: Analyses of the National COVID Cohort Collaborative",

abstract = "Background: Anticoagulation (AC) utilization patterns and their predictors among hospitalized coronavirus disease 2019 (COVID-19) patients have not been well described. Methods: Using the National COVID Cohort Collaborative, we conducted a retrospective cohort study (2020-2022) to assess AC use patterns and identify factors associated with therapeutic AC employing modified Poisson regression. Results: Among 162 842 hospitalized COVID-19 patients, 64% received AC and 24% received therapeutic AC. Therapeutic AC use declined from 32% in 2020 to 12% in 2022, especially after December 2021. Therapeutic AC predictors included age (relative risk [RR], 1.02; 95% confidence interval [CI], 1.02-1.02 per year), male (RR, 1.29; 95% CI, 1.27-1.32), non-Hispanic black (RR, 1.16; 95% CI, 1.13-1.18), obesity (RR, 1.48; 95% CI, 1.43-1.52), increased length of stay (RR, 1.01; 95% CI, 1.01-1.01 per day), and invasive ventilation (RR, 1.64; 95% CI, 1.59-1.69). Vaccination (RR, 0.88; 95% CI, 84-.92) and higher Charlson Comorbidity Index (CCI) (RR, 0.98; 95% CI,. 97-.98) were associated with lower therapeutic AC. Conclusions: Overall, two-thirds of hospitalized COVID-19 patients received any AC and a quarter received therapeutic dosing. Therapeutic AC declined after introduction of the Omicron variant. Predictors of therapeutic AC included demographics, obesity, length of stay, invasive ventilation, CCI, and vaccination, suggesting AC decisions driven by clinical factors including COVID-19 severity, bleeding risks, and comorbidities.",

keywords = "COVID-19, anticoagulation, hospitalization",

author = "Eileen Lee and Benjamin Bates and Nathaniel Kuhrt and Andersen, {Kathleen M.} and Aayush Visaria and Rachel Patel and Soko Setoguchi and Wilcox, {Adam B.} and Lee, {Adam M.} and Alexis Graves and Anzalone, {Alfred (jerrod)} and Amin Manna and Amit Saha and Amy Olex and Andrea Zhou and Williams, {Andrew E.} and Andrew Southerland and Girvin, {Andrew T.} and Anita Walden and Sharathkumar, {Anjali A.} and Benjamin Amor and Benjamin Bates and Brian Hendricks and Brijesh Patel and Caleb Alexander and Carolyn Bramante and Cavin Ward-Caviness and Charisse Madlock-Brown and Christine Suver and Christopher Chute and Christopher Dillon and Chunlei Wu and Clare Schmitt and Cliff Takemoto and Dan Housman and Davera Gabriel and Eichmann, {David A.} and Diego Mazzotti and Don Brown and Eilis Boudreau and Elaine Hill and Elizabeth Zampino and Marti, {Emily Carlson} and Pfaff, {Emily R.} and Evan French and Koraishy, {Farrukh M.} and Federico Mariona and Fred Prior and George Sokos and Greg Martin and Harold Lehmann and Heidi Spratt and Hemalkumar Mehta and Hongfang Liu and Hythem Sidky and Hayanga, {J. W.Awori} and Jami Pincavitch and Jaylyn Clark and Harper, {Jeremy Richard} and Jessica Islam and Jin Ge and Joel Gagnier and Saltz, {Joel H.} and Joel Saltz and Johanna Loomba and John Buse and Jomol Mathew and Rutter, {Joni L.} and McMurry, {Julie A.} and Justin Guinney and Justin Starren and Karen Crowley and Bradwell, {Katie Rebecca} and Walters, {Kellie M.} and Ken Wilkins and Gersing, {Kenneth R.} and Cato, {Kenrick Dwain} and Kimberly Murray and Kristin Kostka and Lavance Northington and Pyles, {Lee Allan} and Leonie Misquitta and Lesley Cottrell and Lili Portilla and Mariam Deacy and Bissell, {Mark M.} and Marshall Clark and Mary Emmett and Saltz, {Mary Morrison} and Palchuk, {Matvey B.} and Haendel, {Melissa A.} and Meredith Adams and Meredith Temple-O'Connor and Kurilla, {Michael G.} and Michele Morris and Nabeel Qureshi and Nasia Safdar and Nicole Garbarini and Noha Sharafeldin and Ofer Sadan and Francis, {Patricia A.} and Burgoon, {Penny Wung} and Peter Robinson and Payne, {Philip R.O.} and Rafael Fuentes and Randeep Jawa and Rebecca Erwin-Cohen and Rena Patel and Moffitt, {Richard A.} and Zhu, {Richard L.} and Rishi Kamaleswaran and Robert Hurley and Miller, {Robert T.} and Saiju Pyarajan and Michael, {Sam G.} and Samuel Bozzette and Sandeep Mallipattu and Satyanarayana Vedula and Scott Chapman and O'Neil, {Shawn T.} and Soko Setoguchi and Hong, {Stephanie S.} and Steve Johnson and Bennett, {Tellen D.} and Tiffany Callahan and Umit Topaloglu and Usman Sheikh and Valery Gordon and Vignesh Subbian and Kibbe, {Warren A.} and Wenndy Hernandez and Will Beasley and Will Cooper and William Hillegass and Zhang, {Xiaohan Tanner} and Alexander, {G. Caleb} and Chute, {Christopher G.} and Moffitt, {Richard A.} and Jasvinder Singh",

year = "2023",

month = oct,

day = "1",

doi = "10.1093/infdis/jiad194",

language = "English (US)",

volume = "228",

pages = "895--906",

journal = "Journal of Infectious Diseases",

issn = "0022-1899",

publisher = "Oxford University Press",

number = "7",

}

TY - JOUR

T1 - National Trends in Anticoagulation Therapy for COVID-19 Hospitalized Adults in the United States

T2 - Analyses of the National COVID Cohort Collaborative

AU - Lee, Eileen

AU - Bates, Benjamin

AU - Kuhrt, Nathaniel

AU - Andersen, Kathleen M.

AU - Visaria, Aayush

AU - Patel, Rachel

AU - Setoguchi, Soko

AU - Wilcox, Adam B.

AU - Lee, Adam M.

AU - Graves, Alexis

AU - Anzalone, Alfred (jerrod)

AU - Manna, Amin

AU - Saha, Amit

AU - Olex, Amy

AU - Zhou, Andrea

AU - Williams, Andrew E.

AU - Southerland, Andrew

AU - Girvin, Andrew T.

AU - Walden, Anita

AU - Sharathkumar, Anjali A.

AU - Amor, Benjamin

AU - Bates, Benjamin

AU - Hendricks, Brian

AU - Patel, Brijesh

AU - Alexander, Caleb

AU - Bramante, Carolyn

AU - Ward-Caviness, Cavin

AU - Madlock-Brown, Charisse

AU - Suver, Christine

AU - Chute, Christopher

AU - Dillon, Christopher

AU - Wu, Chunlei

AU - Schmitt, Clare

AU - Takemoto, Cliff

AU - Housman, Dan

AU - Gabriel, Davera

AU - Eichmann, David A.

AU - Mazzotti, Diego

AU - Brown, Don

AU - Boudreau, Eilis

AU - Hill, Elaine

AU - Zampino, Elizabeth

AU - Marti, Emily Carlson

AU - Pfaff, Emily R.

AU - French, Evan

AU - Koraishy, Farrukh M.

AU - Mariona, Federico

AU - Prior, Fred

AU - Sokos, George

AU - Martin, Greg

AU - Lehmann, Harold

AU - Spratt, Heidi

AU - Mehta, Hemalkumar

AU - Liu, Hongfang

AU - Sidky, Hythem

AU - Hayanga, J. W.Awori

AU - Pincavitch, Jami

AU - Clark, Jaylyn

AU - Harper, Jeremy Richard

AU - Islam, Jessica

AU - Ge, Jin

AU - Gagnier, Joel

AU - Saltz, Joel H.

AU - Saltz, Joel

AU - Loomba, Johanna

AU - Buse, John

AU - Mathew, Jomol

AU - Rutter, Joni L.

AU - McMurry, Julie A.

AU - Guinney, Justin

AU - Starren, Justin

AU - Crowley, Karen

AU - Bradwell, Katie Rebecca

AU - Walters, Kellie M.

AU - Wilkins, Ken

AU - Gersing, Kenneth R.

AU - Cato, Kenrick Dwain

AU - Murray, Kimberly

AU - Kostka, Kristin

AU - Northington, Lavance

AU - Pyles, Lee Allan

AU - Misquitta, Leonie

AU - Cottrell, Lesley

AU - Portilla, Lili

AU - Deacy, Mariam

AU - Bissell, Mark M.

AU - Clark, Marshall

AU - Emmett, Mary

AU - Saltz, Mary Morrison

AU - Palchuk, Matvey B.

AU - Haendel, Melissa A.

AU - Adams, Meredith

AU - Temple-O'Connor, Meredith

AU - Kurilla, Michael G.

AU - Morris, Michele

AU - Qureshi, Nabeel

AU - Safdar, Nasia

AU - Garbarini, Nicole

AU - Sharafeldin, Noha

AU - Sadan, Ofer

AU - Francis, Patricia A.

AU - Burgoon, Penny Wung

AU - Robinson, Peter

AU - Payne, Philip R.O.

AU - Fuentes, Rafael

AU - Jawa, Randeep

AU - Erwin-Cohen, Rebecca

AU - Patel, Rena

AU - Moffitt, Richard A.

AU - Zhu, Richard L.

AU - Kamaleswaran, Rishi

AU - Hurley, Robert

AU - Miller, Robert T.

AU - Pyarajan, Saiju

AU - Michael, Sam G.

AU - Bozzette, Samuel

AU - Mallipattu, Sandeep

AU - Vedula, Satyanarayana

AU - Chapman, Scott

AU - O'Neil, Shawn T.

AU - Setoguchi, Soko

AU - Hong, Stephanie S.

AU - Johnson, Steve

AU - Bennett, Tellen D.

AU - Callahan, Tiffany

AU - Topaloglu, Umit

AU - Sheikh, Usman

AU - Gordon, Valery

AU - Subbian, Vignesh

AU - Kibbe, Warren A.

AU - Hernandez, Wenndy

AU - Beasley, Will

AU - Cooper, Will

AU - Hillegass, William

AU - Zhang, Xiaohan Tanner

AU - Alexander, G. Caleb

AU - Chute, Christopher G.

AU - Moffitt, Richard A.

AU - Singh, Jasvinder

PY - 2023/10/1

Y1 - 2023/10/1

N2 - Background: Anticoagulation (AC) utilization patterns and their predictors among hospitalized coronavirus disease 2019 (COVID-19) patients have not been well described. Methods: Using the National COVID Cohort Collaborative, we conducted a retrospective cohort study (2020-2022) to assess AC use patterns and identify factors associated with therapeutic AC employing modified Poisson regression. Results: Among 162 842 hospitalized COVID-19 patients, 64% received AC and 24% received therapeutic AC. Therapeutic AC use declined from 32% in 2020 to 12% in 2022, especially after December 2021. Therapeutic AC predictors included age (relative risk [RR], 1.02; 95% confidence interval [CI], 1.02-1.02 per year), male (RR, 1.29; 95% CI, 1.27-1.32), non-Hispanic black (RR, 1.16; 95% CI, 1.13-1.18), obesity (RR, 1.48; 95% CI, 1.43-1.52), increased length of stay (RR, 1.01; 95% CI, 1.01-1.01 per day), and invasive ventilation (RR, 1.64; 95% CI, 1.59-1.69). Vaccination (RR, 0.88; 95% CI, 84-.92) and higher Charlson Comorbidity Index (CCI) (RR, 0.98; 95% CI,. 97-.98) were associated with lower therapeutic AC. Conclusions: Overall, two-thirds of hospitalized COVID-19 patients received any AC and a quarter received therapeutic dosing. Therapeutic AC declined after introduction of the Omicron variant. Predictors of therapeutic AC included demographics, obesity, length of stay, invasive ventilation, CCI, and vaccination, suggesting AC decisions driven by clinical factors including COVID-19 severity, bleeding risks, and comorbidities.

AB - Background: Anticoagulation (AC) utilization patterns and their predictors among hospitalized coronavirus disease 2019 (COVID-19) patients have not been well described. Methods: Using the National COVID Cohort Collaborative, we conducted a retrospective cohort study (2020-2022) to assess AC use patterns and identify factors associated with therapeutic AC employing modified Poisson regression. Results: Among 162 842 hospitalized COVID-19 patients, 64% received AC and 24% received therapeutic AC. Therapeutic AC use declined from 32% in 2020 to 12% in 2022, especially after December 2021. Therapeutic AC predictors included age (relative risk [RR], 1.02; 95% confidence interval [CI], 1.02-1.02 per year), male (RR, 1.29; 95% CI, 1.27-1.32), non-Hispanic black (RR, 1.16; 95% CI, 1.13-1.18), obesity (RR, 1.48; 95% CI, 1.43-1.52), increased length of stay (RR, 1.01; 95% CI, 1.01-1.01 per day), and invasive ventilation (RR, 1.64; 95% CI, 1.59-1.69). Vaccination (RR, 0.88; 95% CI, 84-.92) and higher Charlson Comorbidity Index (CCI) (RR, 0.98; 95% CI,. 97-.98) were associated with lower therapeutic AC. Conclusions: Overall, two-thirds of hospitalized COVID-19 patients received any AC and a quarter received therapeutic dosing. Therapeutic AC declined after introduction of the Omicron variant. Predictors of therapeutic AC included demographics, obesity, length of stay, invasive ventilation, CCI, and vaccination, suggesting AC decisions driven by clinical factors including COVID-19 severity, bleeding risks, and comorbidities.

KW - COVID-19

KW - anticoagulation

KW - hospitalization

UR - http://www.scopus.com/inward/record.url?scp=85173570700&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85173570700&partnerID=8YFLogxK

U2 - 10.1093/infdis/jiad194

DO - 10.1093/infdis/jiad194

M3 - Article

C2 - 37265224

AN - SCOPUS:85173570700

SN - 0022-1899

VL - 228

SP - 895

EP - 906

JO - Journal of Infectious Diseases

JF - Journal of Infectious Diseases

IS - 7

ER -

National Trends in Anticoagulation Therapy for COVID-19 Hospitalized Adults in the United States: Analyses of the National COVID Cohort Collaborative

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