Edoxaban for the treatment of pulmonary embolism in hospitalized COVID-19 patients

ABSTRACT

Purpose

We aimed to investigate the clinical performance of edoxaban for the treatment of pulmonary embolism (PE) in hospitalized COVID-19 patients.

Methods

We conducted a retrospective analysis selecting hospitalized patients with COVID-19 admitted to our Institution from 20 May 2020 to 20 November 2020 with computer tomography (CT) detected PE at admission, treated with edoxaban after initial parenteral therapy. Clinical outcomes were compared between patients with and without ARDS at admission and between those with and without CT confirmed PE resolution.

Results

50 patients were included. Mean follow-up was 42.5 ± 10 days. No baseline differences were found between patients with ARDS (30%) and those without ARDS at admission. Patients with PE resolution (84%) were younger (P = 0.03), had a shorter duration of fondaparinux therapy (9.9 ± 3.8 vs 15.8 ± 7.5 days; P = 0.0015) and length of hospitalization (36 ± 8 vs 46 ± 9 days: P = 0.0023) compared with those without PE resolution. 2 patients experienced major bleedings. At multivariate analysis the time to edoxaban switch was the only predictor of the PE resolution (HR: 0.92; 95% C.I. 0.86 to 0.99).

Conclusion

Edoxaban was an effective and safe treatment for acute PE in COVID-19 setting.

KEYWORDS:

• COVID-19
• SARS-CoV-2
• edoxaban
• pulmonary embolism
• ARDS
• safety
• efficacy

Author contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by [Vincenzo Russo], [Valerio Langella] and [Antonio Asti]. The first draft of the manuscript was written by [Roberta Bottino] and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Declaration of interest

The author(s) have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royaltiesThe authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose

Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Ethical approval was waived by the local Ethics Committee in view of the retrospective nature of the study and all the procedures being performed were part of the routine care.

Consent to participate

Informed consent from individual patients was waived due to the observational retrospective design of this study.

Additional information

Funding

This paper was not funded.