Hypercoagulability in coronavirus disease 2019 (COVID-19) may aggravate disease severity during hospitalization but the reported survival benefits from anticoagulation (AC) vary among studies.We performed a literature research to estimate pooled odds ratios (ORs) of in-hospital mortality and major bleeding comparing among intermediate-to-therapeutic dose AC, prophylactic dose AC, and no AC.Until October 22, 2020, PubMed, EMBASE, and Cochrane Library Database were searched for studies reporting AC utilization and mortality in COVID-19.Studies with suspected risk of bias Nursing were excluded before the synthesis of pooled ORs with 95% confidence intervals (CIs) using random-effects models.
Of 37 identified studies (N = 19,510), 17 (N = 17,833) were aggregated in the meta-analysis.The overall mortality rate was 23.1% (95% CI 18.7-28.
2).The pooled odds of mortality comparing anticoagulated to non-anticoagulated patients were similar, but lower in prophylactic dose AC group (OR 0.83; 95% CI 0.73-0.
95).Notably, intermediate-to-therapeutic dose AC increased mortality (OR 1.60; 95% CI 1.11-2.
31) and major bleeding compared Spiral Heater Element to prophylactic dose AC (OR 3.33; 95% CI 2.34-4.72).
Our findings support the optimal efficacy and safety profiles of prophylactic dose AC in hospitalized COVID-19 patients.