BACKGROUND: Thrombotic disease complicates severe SARS-CoV-2 infection and is associated with increased morbidity and mortality . Various anticoagulation strategies have been evaluated in hospitalized patients to prevent complications . The impact of chronic anticoagulation before SARS-CoV-2 infection on the risk for subsequent thrombosis has not been systematically studied .

METHODS: This was a retrospective single-center study . All patients with positive SARS-CoV-2 PCR testing from March 13, 2020, through May 6, 2020, at the University of Rochester Medical Center were identified . We included all patients receiving therapeutic anticoagulation for at least 1 month before COVID diagnosis . We documented the rate of thrombotic complications, type of anticoagulation, bleeding complications, and mortality .

RESULTS: A total of 107 SARS-CoV2-infected patients were chronically anticoagulated before SARS-CoV-2 testing with a median age of 78 . Of those , 42 required hospital admission, with 17 requiring intensive care . No patients, inpatient or outpatient, were diagnosed with a new symptomatic thrombotic complication . Three patients had minor bleeding in the hospital . Thirteen (12 %) patients died (69% male).

CONCLUSION: Our uncontrolled findings suggest that chronic anticoagulation at the time of infection may protect against thrombotic complications and decrease disease severity.