TY - JOUR T1 - Association between oral anticoagulants and COVID-19-related outcomes: a population-based cohort study JF - British Journal of General Practice JO - Br J Gen Pract SP - e456 LP - e463 DO - 10.3399/BJGP.2021.0689 VL - 72 IS - 720 AU - Angel YS Wong AU - Laurie Tomlinson AU - Jeremy P Brown AU - William Elson AU - Alex J Walker AU - Anna Schultze AU - Caroline E Morton AU - David Evans AU - Peter Inglesby AU - Brian MacKenna AU - Krishnan Bhaskaran AU - Christopher T Rentsch AU - Emma Powell AU - Elizabeth Williamson AU - Richard Croker AU - Seb Bacon AU - William Hulme AU - Chris Bates AU - Helen J Curtis AU - Amir Mehrkar AU - Jonathan Cockburn AU - Helen I McDonald AU - Rohini Mathur AU - Kevin Wing AU - Harriet Forbes AU - Rosalind M Eggo AU - Stephen JW Evans AU - Liam Smeeth AU - Ben Goldacre AU - Ian J Douglas AU - (The OpenSAFELY Collaborative) Y1 - 2022/07/01 UR - http://bjgp.org/content/72/720/e456.abstract N2 - Background Early evidence has shown that anticoagulant reduces the risk of thrombotic events in those infected with COVID-19. However, evidence of the role of routinely prescribed oral anticoagulants (OACs) in COVID-19 outcomes is limited.Aim To investigate the association between OACs and COVID-19 outcomes in those with atrial fibrillation and a CHA2DS2-VASc score of 2.Design and setting On behalf of NHS England, a population-based cohort study was conducted.Method The study used primary care data and pseudonymously-linked SARS-CoV-2 antigen testing data, hospital admissions, and death records from England. Cox regression was used to estimate hazard ratios (HRs) for COVID-19 outcomes comparing people with current OAC use versus non-use, accounting for age, sex, comorbidities, other medications, deprivation, and general practice.Results Of 71 103 people with atrial fibrillation and a CHA2DS2-VASc score of 2, there were 52 832 current OAC users and 18 271 non-users. No difference in risk of being tested for SARS-CoV-2 was associated with current use (adjusted HR [aHR] 0.99, 95% confidence interval [CI] = 0.95 to 1.04) versus non-use. A lower risk of testing positive for SARS-CoV-2 (aHR 0.77, 95% CI = 0.63 to 0.95) and a marginally lower risk of COVID-19-related death (aHR, 0.74, 95% CI = 0.53 to 1.04) were associated with current use versus non-use.Conclusion Among those at low baseline stroke risk, people receiving OACs had a lower risk of testing positive for SARS-CoV-2 and severe COVID-19 outcomes than non-users; this might be explained by a causal effect of OACs in preventing severe COVID-19 outcomes or unmeasured confounding, including more cautious behaviours leading to reduced infection risk. ER -