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The following is a summary of “Beyond the Guidelines: Original Research on Real-World Outcomes of Anticoagulation and Corticosteroid in COVID-19,” published in the February 2025 issue of International Journal of Infectious Diseases by Leslie et al. 

The COVID-19 pandemic prompted widespread use of anticoagulation (AC) and corticosteroids (CCS) for hospitalized individuals, though real-world outcomes differed from clinical trial findings due to diverse populations and treatment variability.  

Researchers conducted a retrospective study to assess the real-world impact of AC and CCS therapies on key clinical outcomes in hospitalized individuals with COVID-19.  

They evaluated data from 11 hospitals within a Midwest health system. The study included 4,754 hospitalized individuals with COVID-19 who received AC, CCS, both therapies (AC+CCS), or neither, with the ‘neither’ group serving as the reference. Interventions involved administration of AC, CCS, both AC+CCS, or no treatment. Primary outcomes included thromboembolism (TE), bleeding events, intensive care unit (ICU) admissions, invasive mechanical ventilation (IMV), and in-hospital mortality.  

The results showed that as compared to the reference group, the AC+CCS group had significantly lower odds of TE (adjusted Odds Ratio [aOR] 0.61, 95% CI 0.43-0.87) and bleeding events (aOR 0.15, 95% CI 0.08-0.27). The AC-only group had the lowest rates of ICU admission, IMV, and mortality (aHR 0.30, 95% CI 0.17-0.53). The CCS-only group exhibited the highest rates of adverse outcomes, likely reflecting greater baseline illness severity.  

Investigators concluded the real-world outcomes of anti-cytokine and CCS therapies in patients hospitalized with COVID-19 could vary substantially from those observed in controlled trials. 

Source: ijidonline.com/article/S1201-9712(25)00057-8/fulltext