COVID-19-associated venous thromboembolism: risk of recurrence and major bleeding

被引:3
作者
Demelo-Rodriguez, Pablo [1 ]
Alonso-Beato, Ruben [1 ]
Jara-Palomares, Luis [2 ,3 ,4 ]
Galeano-Valle, Francisco [1 ,11 ]
Bura-Riviere, Alessandra [5 ]
Visona, Adriana [6 ]
Francisco, Iria [7 ]
Vidal, Gemma [8 ]
Lopez-Ruiz, Antonio [9 ]
Monreal, Manuel [10 ]
机构
[1] Hosp Gen Univ Gregorio Maranon, Internal Med Dept, Madrid, Spain
[2] Virgen Rocio Hosp, Resp Dept, Seville, Spain
[3] Inst Biomed, Seville, Spain
[4] Inst Salud Carlos III, CIBER Enfermedades Respiratorias CIBERES, Madrid, Spain
[5] Hop Rangueil, Dept Vasc Med, Toulouse, France
[6] Osped Castelfranco Veneto, Dept Nucl Med, Castelfranco Veneto, Italy
[7] Hosp Univ Girona Dr Josep Trueta, Dept Internal Med, Girona, Spain
[8] Corp Sanitaria Parc Tauli, Dept Internal Med, Barcelona, Spain
[9] Hosp Comarcal Axarquia, Dept Internal Med, Malaga, Spain
[10] Univ Catolica San Antonio Murcia, UCAM, Chair Study Thromboembol Dis, CIBER Enfermedades Respiratorias CIBERES,Fac Hlth, Madrid, Spain
[11] Hosp Gen Univ Gregorio Maranon, Madrid, Spain
关键词
anticoagulants; COVID-19; hemorrhage; pulmonary embolism; venous thromboembolism;
D O I
10.1016/j.rpth.2023.102206
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Complications under anticoagulant treatment in patients with COVID-19-associated venous thromboembolism (VTE) have not been consistently reported.Objectives: This study aimed to compare the 90-day rates of VTE recurrences and major bleeding in patients with COVID-19-associated VTE versus those with VTE without COVID-19.Methods: We used the RIETE registry to compare the 3-month outcomes in patients with COVID-19-associated VTE versus those with VTE without COVID-19.Results: The study included 1,747 patients with COVID-19-associated VTE and 8,711 with VTE without COVID-19. Patients with COVID-19-associated VTE were more likely to be hospitalized at baseline and to present with pulmonary embolism. During the first 90 days, 123 patients (1.17%) developed VTE recurrences, and 266 (2.54%) experienced major bleeding. Patients with COVID-19-associated VTE had a similar rate of VTE recurrences (0.9% vs 1.2%) but a higher rate of major bleeding (4.6% vs 2.1%; P < .001) than those without COVID-19. Multivariable analysis adjusted for competing risks showed that patients with COVID-19-associated VTE had an increased risk of major bleeding (subhazard ratio, 1.395; 95% confidence interval, 1.037-1.877). The 30-day mortality after major bleeding was 26.3% in patients with COVID-19-associated VTE and 17.7% in those without COVID-19.Conclusion: Patients with COVID-19-associated VTE had a 5-fold higher rate of major bleeding than VTE recurrences during the first 90 days of anticoagulation. In VTE patients without COVID-19, both rates were similar. These findings highlight the importance of carefully monitoring and optimizing anticoagulation in these patients.
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页数:8
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