{
    "abstract": "The COVID-19 pandemic has led to the widespread use of anticoagulation (AC) and corticosteroids (CCS) for hospitalized patients, but real-world outcomes may differ from clinical trial findings due to diverse patient populations and treatment variability.\nTo evaluate the real-world impact of AC and CCS therapies on key clinical outcomes in hospitalized COVID-19 patients.\nMulticenter, retrospective observational cohort study conducted across 11 hospitals in a Midwest health system.\nThe study included 4754 hospitalized COVID-19 patients treated with AC, CCS, both (AC+CCS), or neither. The 'neither' group served as the reference for comparisons.\nInterventions included administration of AC, CCS, both AC+CCS, or no intervention.\nPrimary outcomes included thromboembolism (TE), bleeding events, ICU admissions, invasive mechanical ventilation (IMV), and in-hospital mortality.\nCompared to the reference group, the AC+CCS group had significantly lower odds of TE (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 demonstrated the lowest ICU admission, IMV, and mortality rates (aHR 0.30 95% CI (0.17, 0.53)). The CCS-only group had the highest rates of adverse outcomes, likely reflecting greater baseline illness severity.\nThis study emphasizes the importance of individualized treatment strategies in hospitalized COVID-19 patients, showing that real-world outcomes of AC and CCS can differ significantly from controlled trials. These findings provide crucial insights for adapting clinical guidelines to diverse patient settings.",
    "authors": [
        {
            "affiliation": "Hospital of the University of Pennsylvania, Division of General Internal Medicine, Philadelphia, PA, USA.",
            "firstname": "Alison",
            "initials": "A",
            "lastname": "Leslie"
        },
        {
            "affiliation": "Department of Experimental and Clinical Pharmacology, University of Minnesota College of Pharmacy, Minneapolis, MN, USA.",
            "firstname": "Scott A",
            "initials": "SA",
            "lastname": "Chapman"
        },
        {
            "affiliation": "University of Minnesota Masonic Cancer Center, Biostatistics Core, Minneapolis, MN, USA.",
            "firstname": "Katelyn M",
            "initials": "KM",
            "lastname": "Tessier"
        },
        {
            "affiliation": "Department of Surgery, University of Minnesota, Minneapolis, MN, USA.",
            "firstname": "Christopher",
            "initials": "C",
            "lastname": "Tignanelli"
        },
        {
            "affiliation": "Division of Hospital Medicine, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA; Division of Hospital Internal Medicine, Department of Medicine, Mayo Clinic, Scottsdale, AZ, USA. Electronic address: shozayen@umn.edu.",
            "firstname": "Sameh",
            "initials": "S",
            "lastname": "Hozayen"
        }
    ],
    "conclusions": null,
    "copyrights": "Copyright \u00a9 2025 The Author(s). Published by Elsevier Ltd.. All rights reserved.",
    "doi": "10.1016/j.ijid.2025.107834",
    "journal": "International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases",
    "keywords": [
        "Bleeding",
        "Hospital length of stay",
        "Intensive care unit admission",
        "Invasive mechanical ventilation",
        "Thromboembolic events",
        "Thrombosis"
    ],
    "methods": null,
    "publication_date": "2025-02-11",
    "pubmed_id": "39929317",
    "results": null,
    "title": "Beyond the guidelines: original research on real-world outcomes of anticoagulation and corticosteroid in COVID-19.",
    "xml": "<Element 'PubmedArticle' at 0x788506b2a110>"
}