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Venous thromboembolism secondary to hospitalization for COVID-19: patient management and long-term outcomes
BACKGROUND: Venous thromboembolism (VTE) is a complication of COVID-19 in hospitalized patients. Little information is available on long-term outcomes of VTE in this population. OBJECTIVES: We aimed to compare the characteristics, management strategies, and long-term clinical outcomes between patien...
Autores principales: | , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10131739/ https://www.ncbi.nlm.nih.gov/pubmed/37229314 http://dx.doi.org/10.1016/j.rpth.2023.100167 |
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author | Ageno, Walter Antonucci, Emilia Poli, Daniela Bucherini, Eugenio Chistolini, Antonio Fregoni, Vittorio Lerede, Teresa Pancani, Roberta Pedrini, Simona Pieralli, Filippo Pignatelli, Pasquale Pizzini, Attilia Maria Podda, Gian Marco Potere, Nicola Sarti, Luca Testa, Sophie Visonà, Adriana Palareti, Gualtiero |
author_facet | Ageno, Walter Antonucci, Emilia Poli, Daniela Bucherini, Eugenio Chistolini, Antonio Fregoni, Vittorio Lerede, Teresa Pancani, Roberta Pedrini, Simona Pieralli, Filippo Pignatelli, Pasquale Pizzini, Attilia Maria Podda, Gian Marco Potere, Nicola Sarti, Luca Testa, Sophie Visonà, Adriana Palareti, Gualtiero |
author_sort | Ageno, Walter |
collection | PubMed |
description | BACKGROUND: Venous thromboembolism (VTE) is a complication of COVID-19 in hospitalized patients. Little information is available on long-term outcomes of VTE in this population. OBJECTIVES: We aimed to compare the characteristics, management strategies, and long-term clinical outcomes between patients with COVID-19–associated VTE and patients with VTE provoked by hospitalization for other acute medical illnesses. METHODS: This is an observational cohort study, with a prospective cohort of 278 patients with COVID-19–associated VTE enrolled between 2020 and 2021 and a comparison cohort of 300 patients without COVID-19 enrolled in the ongoing START2-Register between 2018 and 2020. Exclusion criteria included age <18 years, other indications to anticoagulant treatment, active cancer, recent (<3 months) major surgery, trauma, pregnancy, and participation in interventional studies. All patients were followed up for a minimum of 12 months after treatment discontinuation. Primary end point was the occurrence of venous and arterial thrombotic events. RESULTS: Patients with VTE secondary to COVID-19 had more frequent pulmonary embolism without deep vein thrombosis than controls (83.1% vs 46.2%, P <.001), lower prevalence of chronic inflammatory disease (1.4% and 16.3%, P <.001), and history of VTE (5.0% and 19.0%, P <.001). The median duration of anticoagulant treatment (194 and 225 days, P = 0.9) and the proportion of patients who discontinued anticoagulation (78.0% and 75.0%, P = 0.4) were similar between the 2 groups. Thrombotic event rates after discontinuation were 1.5 and 2.6 per 100 patient-years, respectively (P = 0.4). CONCLUSION: The risk of recurrent thrombotic events in patients with COVID-19–associated VTE is low and similar to the risk observed in patients with VTE secondary to hospitalization for other medical diseases. |
format | Online Article Text |
id | pubmed-10131739 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-101317392023-04-26 Venous thromboembolism secondary to hospitalization for COVID-19: patient management and long-term outcomes Ageno, Walter Antonucci, Emilia Poli, Daniela Bucherini, Eugenio Chistolini, Antonio Fregoni, Vittorio Lerede, Teresa Pancani, Roberta Pedrini, Simona Pieralli, Filippo Pignatelli, Pasquale Pizzini, Attilia Maria Podda, Gian Marco Potere, Nicola Sarti, Luca Testa, Sophie Visonà, Adriana Palareti, Gualtiero Res Pract Thromb Haemost Original Article BACKGROUND: Venous thromboembolism (VTE) is a complication of COVID-19 in hospitalized patients. Little information is available on long-term outcomes of VTE in this population. OBJECTIVES: We aimed to compare the characteristics, management strategies, and long-term clinical outcomes between patients with COVID-19–associated VTE and patients with VTE provoked by hospitalization for other acute medical illnesses. METHODS: This is an observational cohort study, with a prospective cohort of 278 patients with COVID-19–associated VTE enrolled between 2020 and 2021 and a comparison cohort of 300 patients without COVID-19 enrolled in the ongoing START2-Register between 2018 and 2020. Exclusion criteria included age <18 years, other indications to anticoagulant treatment, active cancer, recent (<3 months) major surgery, trauma, pregnancy, and participation in interventional studies. All patients were followed up for a minimum of 12 months after treatment discontinuation. Primary end point was the occurrence of venous and arterial thrombotic events. RESULTS: Patients with VTE secondary to COVID-19 had more frequent pulmonary embolism without deep vein thrombosis than controls (83.1% vs 46.2%, P <.001), lower prevalence of chronic inflammatory disease (1.4% and 16.3%, P <.001), and history of VTE (5.0% and 19.0%, P <.001). The median duration of anticoagulant treatment (194 and 225 days, P = 0.9) and the proportion of patients who discontinued anticoagulation (78.0% and 75.0%, P = 0.4) were similar between the 2 groups. Thrombotic event rates after discontinuation were 1.5 and 2.6 per 100 patient-years, respectively (P = 0.4). CONCLUSION: The risk of recurrent thrombotic events in patients with COVID-19–associated VTE is low and similar to the risk observed in patients with VTE secondary to hospitalization for other medical diseases. Elsevier 2023-04-26 /pmc/articles/PMC10131739/ /pubmed/37229314 http://dx.doi.org/10.1016/j.rpth.2023.100167 Text en © 2023 The Author(s) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Original Article Ageno, Walter Antonucci, Emilia Poli, Daniela Bucherini, Eugenio Chistolini, Antonio Fregoni, Vittorio Lerede, Teresa Pancani, Roberta Pedrini, Simona Pieralli, Filippo Pignatelli, Pasquale Pizzini, Attilia Maria Podda, Gian Marco Potere, Nicola Sarti, Luca Testa, Sophie Visonà, Adriana Palareti, Gualtiero Venous thromboembolism secondary to hospitalization for COVID-19: patient management and long-term outcomes |
title | Venous thromboembolism secondary to hospitalization for COVID-19: patient management and long-term outcomes |
title_full | Venous thromboembolism secondary to hospitalization for COVID-19: patient management and long-term outcomes |
title_fullStr | Venous thromboembolism secondary to hospitalization for COVID-19: patient management and long-term outcomes |
title_full_unstemmed | Venous thromboembolism secondary to hospitalization for COVID-19: patient management and long-term outcomes |
title_short | Venous thromboembolism secondary to hospitalization for COVID-19: patient management and long-term outcomes |
title_sort | venous thromboembolism secondary to hospitalization for covid-19: patient management and long-term outcomes |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10131739/ https://www.ncbi.nlm.nih.gov/pubmed/37229314 http://dx.doi.org/10.1016/j.rpth.2023.100167 |
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