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Incidence and Predictors of Thrombotic Complications in 4742 Patients with COVID-19 or Other Acute Infectious Respiratory Diseases: A Propensity Score-Matched Study

Background. A prothrombotic state, attributable to excessive inflammation, cytokine storm, hypoxia, and immobilization, is a feature of SARS-CoV-2 infection. Up to 30% of patients with severe COVID-19 remain at high risk of thromboembolic events despite anticoagulant administration, with adverse imp...

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Autores principales: De Vita, Antonio, De Matteis, Giuseppe, d’Aiello, Alessia, Ravenna, Salvatore Emanuele, Liuzzo, Giovanna, Lanza, Gaetano Antonio, Massetti, Massimo, Crea, Filippo, Gasbarrini, Antonio, Franceschi, Francesco, Covino, Marcello
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8584832/
https://www.ncbi.nlm.nih.gov/pubmed/34768490
http://dx.doi.org/10.3390/jcm10214973
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author De Vita, Antonio
De Matteis, Giuseppe
d’Aiello, Alessia
Ravenna, Salvatore Emanuele
Liuzzo, Giovanna
Lanza, Gaetano Antonio
Massetti, Massimo
Crea, Filippo
Gasbarrini, Antonio
Franceschi, Francesco
Covino, Marcello
author_facet De Vita, Antonio
De Matteis, Giuseppe
d’Aiello, Alessia
Ravenna, Salvatore Emanuele
Liuzzo, Giovanna
Lanza, Gaetano Antonio
Massetti, Massimo
Crea, Filippo
Gasbarrini, Antonio
Franceschi, Francesco
Covino, Marcello
author_sort De Vita, Antonio
collection PubMed
description Background. A prothrombotic state, attributable to excessive inflammation, cytokine storm, hypoxia, and immobilization, is a feature of SARS-CoV-2 infection. Up to 30% of patients with severe COVID-19 remain at high risk of thromboembolic events despite anticoagulant administration, with adverse impact on in-hospital prognosis. Methods. We retrospectively studied 4742 patients with acute infectious respiratory disease (AIRD); 2579 were diagnosed to have COVID-19 and treated with heparin, whereas 2163 had other causes of AIRD. We compared the incidence and predictors of total, arterial, and venous thrombosis, both in the whole population and in a propensity score-matched subpopulation of 3036 patients (1518 in each group). Results. 271 thrombotic events occurred in the whole population: 121 (4.7%) in the COVID-19 group and 150 (6.9%) in the no-COVID-19 group (p < 0.001). No differences in the incidence of total (p = 0.11), arterial (p = 0.26), and venous (p = 0.38) thrombosis were found between the two groups after adjustment for confounding clinical variables and in the propensity score-matched subpopulation. Likewise, there were no significant differences in bleeding rates between the two groups. Clinical predictors of arterial thrombosis included age (p = 0.006), diabetes mellitus (p = 0.034), peripheral artery disease (p < 0.001), and previous stroke (p < 0.001), whereas history of solid cancer (p < 0.001) and previous deep vein thrombosis (p = 0.007) were associated with higher incidence of venous thrombosis. Conclusions. Hospitalized patients with COVID-19 treated with heparin do not seem to show significant differences in the cumulative incidence of thromboembolic events as well as in the incidence of arterial and venous thrombosis separately, compared with AIRD patients with different etiological diagnosis.
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spelling pubmed-85848322021-11-12 Incidence and Predictors of Thrombotic Complications in 4742 Patients with COVID-19 or Other Acute Infectious Respiratory Diseases: A Propensity Score-Matched Study De Vita, Antonio De Matteis, Giuseppe d’Aiello, Alessia Ravenna, Salvatore Emanuele Liuzzo, Giovanna Lanza, Gaetano Antonio Massetti, Massimo Crea, Filippo Gasbarrini, Antonio Franceschi, Francesco Covino, Marcello J Clin Med Article Background. A prothrombotic state, attributable to excessive inflammation, cytokine storm, hypoxia, and immobilization, is a feature of SARS-CoV-2 infection. Up to 30% of patients with severe COVID-19 remain at high risk of thromboembolic events despite anticoagulant administration, with adverse impact on in-hospital prognosis. Methods. We retrospectively studied 4742 patients with acute infectious respiratory disease (AIRD); 2579 were diagnosed to have COVID-19 and treated with heparin, whereas 2163 had other causes of AIRD. We compared the incidence and predictors of total, arterial, and venous thrombosis, both in the whole population and in a propensity score-matched subpopulation of 3036 patients (1518 in each group). Results. 271 thrombotic events occurred in the whole population: 121 (4.7%) in the COVID-19 group and 150 (6.9%) in the no-COVID-19 group (p < 0.001). No differences in the incidence of total (p = 0.11), arterial (p = 0.26), and venous (p = 0.38) thrombosis were found between the two groups after adjustment for confounding clinical variables and in the propensity score-matched subpopulation. Likewise, there were no significant differences in bleeding rates between the two groups. Clinical predictors of arterial thrombosis included age (p = 0.006), diabetes mellitus (p = 0.034), peripheral artery disease (p < 0.001), and previous stroke (p < 0.001), whereas history of solid cancer (p < 0.001) and previous deep vein thrombosis (p = 0.007) were associated with higher incidence of venous thrombosis. Conclusions. Hospitalized patients with COVID-19 treated with heparin do not seem to show significant differences in the cumulative incidence of thromboembolic events as well as in the incidence of arterial and venous thrombosis separately, compared with AIRD patients with different etiological diagnosis. MDPI 2021-10-26 /pmc/articles/PMC8584832/ /pubmed/34768490 http://dx.doi.org/10.3390/jcm10214973 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
De Vita, Antonio
De Matteis, Giuseppe
d’Aiello, Alessia
Ravenna, Salvatore Emanuele
Liuzzo, Giovanna
Lanza, Gaetano Antonio
Massetti, Massimo
Crea, Filippo
Gasbarrini, Antonio
Franceschi, Francesco
Covino, Marcello
Incidence and Predictors of Thrombotic Complications in 4742 Patients with COVID-19 or Other Acute Infectious Respiratory Diseases: A Propensity Score-Matched Study
title Incidence and Predictors of Thrombotic Complications in 4742 Patients with COVID-19 or Other Acute Infectious Respiratory Diseases: A Propensity Score-Matched Study
title_full Incidence and Predictors of Thrombotic Complications in 4742 Patients with COVID-19 or Other Acute Infectious Respiratory Diseases: A Propensity Score-Matched Study
title_fullStr Incidence and Predictors of Thrombotic Complications in 4742 Patients with COVID-19 or Other Acute Infectious Respiratory Diseases: A Propensity Score-Matched Study
title_full_unstemmed Incidence and Predictors of Thrombotic Complications in 4742 Patients with COVID-19 or Other Acute Infectious Respiratory Diseases: A Propensity Score-Matched Study
title_short Incidence and Predictors of Thrombotic Complications in 4742 Patients with COVID-19 or Other Acute Infectious Respiratory Diseases: A Propensity Score-Matched Study
title_sort incidence and predictors of thrombotic complications in 4742 patients with covid-19 or other acute infectious respiratory diseases: a propensity score-matched study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8584832/
https://www.ncbi.nlm.nih.gov/pubmed/34768490
http://dx.doi.org/10.3390/jcm10214973
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