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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
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.
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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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