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

被引:2
作者
De Vita, Antonio [1 ]
De Matteis, Giuseppe [2 ]
d'Aiello, Alessia [1 ]
Ravenna, Salvatore Emanuele [1 ]
Liuzzo, Giovanna [1 ]
Lanza, Gaetano Antonio [1 ]
Massetti, Massimo [1 ]
Crea, Filippo [1 ]
Gasbarrini, Antonio [2 ]
Franceschi, Francesco [3 ]
Covino, Marcello [3 ]
机构
[1] Univ Cattolica Sacro Cuore, Fdn Policlin Univ A Gemelli IRCCS, Dept Cardiovasc Sci, I-00168 Rome, Italy
[2] Univ Cattolica Sacro Cuore, Fdn Policlin Univ A Gemelli IRCCS, Dept Clin & Surg Sci, I-00168 Rome, Italy
[3] Univ Cattolica Sacro Cuore, Fdn Policlin Univ A Gemelli IRCCS, Dept Emergency Med, I-00168 Rome, Italy
关键词
acute infectious respiratory disease; COVID-19; SARS-CoV-2; infection; thrombosis; thromboembolic events; ANTICOAGULATION; DEFINITION; GUIDELINES; WUHAN;
D O I
10.3390/jcm10214973
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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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