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Article

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

1
Department of Geriatric Medicine, Le Mans Hospital, F-72037 Le Mans, France
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Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity, University Hospital, F-49933 Angers, France
3
INSERM, MINT, 1066, University of Angers, F-49000 Angers, France
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Delegation to Clinical Research and Innovation, Angers University Hospital, F-49933 Angers, France
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UPRES EA 4638, University of Angers, F-49000 Angers, France
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Gérontopôle Autonomie Longévité des Pays de la Loire, F-44000 Nantes, France
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Robarts Research Institute, Department of Medical Biophysics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON N6A 5K8, Canada
*
Author to whom correspondence should be addressed.
Membership of the GERIA-COVID study group is provided in the Acknowledgments.
Nutrients 2021, 13(1), 39; https://doi.org/10.3390/nu13010039
Received: 26 November 2020 / Revised: 20 December 2020 / Accepted: 22 December 2020 / Published: 24 December 2020
(This article belongs to the Section Micronutrients and Human Health)
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. View Full-Text
Keywords: COVID-19; SARS-CoV-2; vitamin K antagonist; anticoagulation; survival; older adults COVID-19; SARS-CoV-2; vitamin K antagonist; anticoagulation; survival; older adults
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MDPI and ACS Style

Ménager, P.; Brière, O.; Gautier, J.; Riou, J.; Sacco, G.; Brangier, A.; Annweiler, C.; on behalf of the GERIA-COVID study group. 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. Nutrients 2021, 13, 39. https://doi.org/10.3390/nu13010039

AMA Style

Ménager P, Brière O, Gautier J, Riou J, Sacco G, Brangier A, Annweiler C, on behalf of the GERIA-COVID study group. 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. Nutrients. 2021; 13(1):39. https://doi.org/10.3390/nu13010039

Chicago/Turabian Style

Ménager, Pierre, Olivier Brière, Jennifer Gautier, Jérémie Riou, Guillaume Sacco, Antoine Brangier, Cédric Annweiler, and on behalf of the GERIA-COVID study group. 2021. "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" Nutrients 13, no. 1: 39. https://doi.org/10.3390/nu13010039

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