We appreciate the interest of Rujittika Mungmunpuntipantip and Viroj Wiwanitkit1 in our study. We agree that there are no data suggesting biological mechanisms of COVID-19 infection that could be linked to the pharmacological action of warfarin. However, when we designed the study we aimed to test the hypothesis that general variations in health status of patients due to an inf lammatory reaction to vaccination could modify the response to warfarin treatment. It is known that the determinants of the quality
of anticoagulant therapy are inf luenced by associated diseases, such as heart failure, diabetes and intercurrent illness2-4.
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