Arterial and Venous Thrombosis Complicated in COVID-19: A Retrospective Single Center Analysis in Japan

被引:24
作者
Oba, Seiya [1 ]
Hosoya, Tadashi [1 ]
Amamiya, Miki [2 ]
Mitsumura, Takahiro [3 ]
Kawata, Daisuke [1 ]
Sasaki, Hirokazu [1 ]
Kamiya, Mari [1 ]
Yamamoto, Akio [1 ]
Ando, Takahiro [3 ]
Shimada, Sho [3 ]
Shirai, Tsuyoshi [3 ]
Okamoto, Tsukasa [3 ]
Tateishi, Tomoya [3 ]
Endo, Akira [4 ]
Aiboshi, Junichi [4 ]
Nosaka, Nobuyuki [5 ]
Yamanouchi, Hideo [5 ]
Ugawa, Toyomu [5 ]
Nagaoka, Eiki [6 ]
Oi, Keiji [6 ]
Tao, Susumu [2 ]
Maejima, Yasuhiro [2 ]
Tanaka, Yukie [7 ]
Tanimoto, Kousuke [7 ,8 ]
Takeuchi, Hiroaki [9 ]
Tohda, Shuji [10 ]
Hirakawa, Akihiro [11 ]
Sasano, Tetsuo [2 ]
Arai, Hirokuni [6 ]
Otomo, Yasuhiro [4 ]
Miyazaki, Yasunari [3 ]
Yasuda, Shinsuke [1 ]
机构
[1] Tokyo Med & Dent Univ TMDU, Grad Sch Med & Dent Sci, Dept Rheumatol, Tokyo, Japan
[2] Tokyo Med & Dent Univ TMDU, Grad Sch Med & Dent Sci, Dept Cardiovasc Med, Tokyo, Japan
[3] Tokyo Med & Dent Univ TMDU, Grad Sch Med & Dent Sci, Dept Resp Med, Tokyo, Japan
[4] Tokyo Med & Dent Univ TMDU, Grad Sch Med & Dent Sci, Trauma & Acute Crit Care Med Ctr, Tokyo, Japan
[5] Tokyo Med & Dent Univ TMDU, Grad Sch Med & Dent Sci, Dept Intens Care Med, Tokyo, Japan
[6] Tokyo Med & Dent Univ TMDU, Grad Sch Med & Dent Sci, Dept Cardiovasc Surg, Tokyo, Japan
[7] Tokyo Med & Dent Univ TMDU, Inst Res, Res Core, Tokyo, Japan
[8] Tokyo Med & Dent Univ TMDU, Med Res Inst, Genome Lab, Tokyo, Japan
[9] Tokyo Med & Dent Univ TMDU, Dept Mol Virol, Tokyo, Japan
[10] Tokyo Med & Dent Univ TMDU Hosp, Clin Lab, Tokyo, Japan
[11] Tokyo Med & Dent Univ TMDU, Grad Sch Med & Dent Sci, Dept Clin Biostat, Tokyo, Japan
来源
FRONTIERS IN CARDIOVASCULAR MEDICINE | 2021年 / 8卷
关键词
thrombosis; COVID-19; coagulopathy; D-dimer; variant of concern; DEEP-VEIN THROMBOSIS; ANTICOAGULATION; ASSOCIATION; INFECTION; EPIDEMIC;
D O I
10.3389/fcvm.2021.767074
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Thrombosis is a characteristic complication in coronavirus disease 2019 (COVID-19). Since coagulopathy has been observed over the entire clinical course, thrombosis might be a clue to understanding the specific pathology in COVID-19. Currently, there is limited epidemiological data of COVID-19-associated thrombosis in the Japanese population and none regarding variant strains of SARS-CoV-2. Here, we elucidate the risk factors and the pattern of thrombosis in COVID-19 patients.Methods: The patients consecutively admitted to Tokyo Medical and Dental University Hospital with COVID-19 were retrospectively analyzed. SARS-CoV-2 variants of concern/interest (VOC/VOI) carrying the spike protein mutants E484K, N501Y, or L452R were identified by PCR-based analysis. All thrombotic events were diagnosed by clinical symptoms, ultrasonography, and/or radiological tests.Results: Among the 516 patients, 32 patients experienced 42 thromboembolic events. Advanced age, severe respiratory conditions, and several abnormal laboratory markers were associated with the development of thrombosis. While thrombotic events occurred in 13% of the patients with a severe respiratory condition, those events still occurred in 2.5% of the patients who did not require oxygen therapy. Elevated D-dimer and ferritin levels on admission were independent risk factors of thrombosis (adjusted odds ratio 9.39 and 3.11, 95% confidence interval 2.08-42.3, and 1.06-9.17, respectively). Of the thrombotic events, 22 were venous, whereas 20 were arterial. While patients with thrombosis received anticoagulation and antiinflammatory therapies with a higher proportion, the mortality rate, organ dysfunctions, and bleeding complications in these patients were higher than those without thrombosis. The incidence of thrombosis in COVID-19 became less frequent over time, such as during the replacement of the earlier strains of SARS-CoV-2 by VOC/VOI and during increased use of anticoagulatory therapeutics.Conclusion: This study elucidated that elevated D-dimer and ferritin levels are useful biomarkers of thrombosis in COVID-19 patients. The comparable incidence of arterial thrombosis with venous thrombosis and the development of thrombosis in less severe patients required further considerations for the management of Japanese patients with COVID-19. Further studies would be required to identify high-risk populations and establish appropriate interventions for thrombotic complications in COVID-19.
引用
收藏
页数:13
相关论文
共 50 条
[41]   A single-center comparative analysis of outpatients with and without COVID-19 in Sapporo, Japan [J].
Shimamura, Yoshinosuke ;
Masuda, Kaihei ;
Anbo, Yoshiyasu ;
Sugaya, Fumiko ;
Furuta, Yasushi .
JOURNAL OF GENERAL AND FAMILY MEDICINE, 2022, 23 (01) :61-64
[42]   Acute Pulmonary Artery Thrombosis despite Anticoagulation in Patients with COVID-19 Pneumonia: A Single-Center Retrospective Cohort Study [J].
Niculae, Cristian-Mihail ;
Anghel, Ana-Maria-Jennifer ;
Militaru, Eliza-Daniela ;
Tirlescu, Laura-Georgiana ;
Lazar, Mihai ;
Hristea, Adriana .
JOURNAL OF CLINICAL MEDICINE, 2022, 11 (09)
[43]   Cerebral deep venous thrombosis and COVID-19: case report [J].
Hoelscher, Christian ;
Sweid, Ahmad ;
Ghosh, Ritam ;
Saiegh, Fadi Al ;
Keppetipola, Kavantissa M. ;
Farrell, Christopher J. ;
Jallo, Jack ;
Jabbour, Pascal ;
Tjoumakaris, Stavropoula ;
Gooch, Reid ;
Rosenwasser, Robert H. ;
Shah, Syed O. .
JOURNAL OF NEUROSURGERY, 2021, 135 (01) :17-20
[44]   Safety and Tolerability of COVID-19 Vaccines in Patients with Cancer: A Single Center Retrospective Analysis [J].
Nuzzo, Amedeo ;
Manacorda, Simona ;
Sammarco, Enrico ;
Sbrana, Andrea ;
Bazzurri, Serena ;
Paolieri, Federico ;
Manfredi, Fiorella ;
Mercinelli, Chiara ;
Ferrari, Marco ;
Massaro, Giulia ;
Bonato, Adele ;
Salfi, Alessia ;
Galli, Luca ;
Morganti, Riccardo ;
Antonuzzo, Andrea ;
Cremolini, Chiara ;
Masi, Gianluca .
VACCINES, 2022, 10 (06)
[45]   Venous Thromboembolism in Hospitalized COVID-19 Patients [J].
Sridharan, Gurusaravanan Kutti ;
Vegunta, Radhakrishna ;
Rokkam, Venkata Ram Pradeep ;
Aravamudan, Veeraraghavan Meyyur ;
Vegunta, Rathnamitreyee ;
Khan, Shahab R. ;
Ponnada, Suresh ;
Boregowda, Umesha ;
Prudhvi, Kalyan ;
Chamarthi, Gajapathiraju ;
Mohan, Babu P. .
AMERICAN JOURNAL OF THERAPEUTICS, 2020, 27 (06) :E599-E610
[46]   Outcomes in COVID-19 Patients with Acute Cholangitis: A Single-Center Retrospective Analysis [J].
Vuletici, Deiana ;
Miutescu, Bogdan ;
Burciu, Calin ;
Ratiu, Iulia ;
Moga, Tudor ;
Gadour, Eyad ;
Motofelea, Alexandru Catalin ;
Koppandi, Oana ;
Sirli, Roxana ;
Popescu, Alina .
MEDICINA-LITHUANIA, 2024, 60 (08)
[47]   Importance of Insulin Resistance in the COVID-19 Era: A Retrospective Analysis of a Single Center in Mexico [J].
Peralta Amaro, Ana L. ;
Ramirez Ventura, Julio C. ;
Banuelos Garcia, Luis R. ;
Pecero Garcia, Emily, I ;
Valadez Calderon, Jose G. ;
Hernandez Flandes, Rosa N. .
CUREUS JOURNAL OF MEDICAL SCIENCE, 2022, 14 (09)
[48]   Prognosis analysis of patients with mental disorders with COVID-19: a single -center retrospective study [J].
Wan, Yan ;
Wu, Juan ;
Ni, Lihua ;
Luo, Qinqin ;
Yuan, Cheng ;
Fan, Fang ;
Liu, Hong ;
Zhang, Changjiang ;
Xiang, Yuandi ;
Xie, Qin .
AGING-US, 2020, 12 (12) :11238-11244
[49]   Thyroid Incidentalomas in Hospitalized Patients With COVID-19: A Single-Center Retrospective Analysis [J].
Jantarapootirat, Methus ;
Traiwanatham, Sirinapa ;
Hirunpat, Pornrujee ;
Boonsomsuk, Woranan ;
Sungkanuparph, Somnuek ;
Sriphrapradang, Chutintorn .
JOURNAL OF THE ENDOCRINE SOCIETY, 2023, 7 (06)
[50]   Comparative study of ensitrelvir and symptomatic therapy in healthcare workers with mild COVID-19: A single center retrospective analysis in Chiba, Japan [J].
Hirai, Jun ;
Hanai, Yuki .
JOURNAL OF INFECTION AND CHEMOTHERAPY, 2025, 31 (04)