학술논문
Doxycycline’s Potential Role in Reducing Thrombosis and Mortality in Critically Ill Patients With COVID-19: A Multicenter Cohort Study
Document Type
article
Author
Khalid Al Sulaiman MBA, BCCCP, BCNSP, FCCM; Ohoud Aljuhani PharmD; Ghazwa B. Korayem PharmD; Lina I. Alnajjar PharmD; Ali F. Altebainawi PharmD; Mashael AlFaifi PharmD; Ramesh Vishwakarma PhD; Abeer A. Alenazi PharmD; Mai Alalawi PharmD; Abdulrahman Alissa PharmD; Yazed S. Alsowaida BSc, PharmD; Samiah Alsohimi PharmD; Alaa Almagthali PharmD; Saeed M. Alay PharmD; Noora Altaher PharmD; Mohammed G. Alamri PharmD; Dalal Alangari PharmD; Amer Alzahrani MD; Habeeb Ibrahim Abdul Razack MPharm, MSc CRRA; Jwael Alhamoud BSc; Abdulrahman Alshaya PharmD; Jawaher Gramish PharmD; Kholoud Al Aamer MSc; Alawi S. Alsaeedi MD; Ghassan Alghamdi MD
Source
Clinical and Applied Thrombosis/Hemostasis, Vol 29 (2023)
Subject
Language
English
ISSN
1938-2723
10760296
10760296
Abstract
Doxycycline has revealed potential effects in animal studies to prevent thrombosis and reduce mortality. However, less is known about its antithrombotic role in patients with COVID-19. Our study aimed to evaluate doxycycline's impact on clinical outcomes in critically ill patients with COVID-19. A multicenter retrospective cohort study was conducted between March 1, 2020, and July 31, 2021. Patients who received doxycycline in intensive care units (ICUs) were compared to patients who did not (control). The primary outcome was the composite thrombotic events. The secondary outcomes were 30-day and in-hospital mortality, length of stay, ventilator-free days, and complications during ICU stay. Propensity score (PS) matching was used based on the selected criteria. Logistic, negative binomial, and Cox proportional hazards regression analyses were used as appropriate. After PS (1:3) matching, 664 patients (doxycycline n = 166, control n = 498) were included. The number of thromboembolic events was lower in the doxycycline group (OR: 0.54; 95% CI: 0.26-1.08; P = .08); however, it failed to reach to a statistical significance. Moreover, D-dimer levels and 30-day mortality were lower in the doxycycline group (beta coefficient [95% CI]: −0.22 [−0.46, 0.03; P = .08]; HR: 0.73; 95% CI: 0.52-1.00; P = .05, respectively). In addition, patients who received doxycycline had significantly lower odds of bacterial/fungal pneumonia (OR: 0.65; 95% CI: 0.44-0.94; P = .02). The use of doxycycline as adjunctive therapy in critically ill patients with COVID-19 might may be a desirable therapeutic option for thrombosis reduction and survival benefits.