Presenting Characteristics, Treatment Patterns, and Outcomes among Patients with Venous Thromboembolism during Hospitalization for COVID-19
Presenting Characteristics, Treatment Patterns, and Outcomes among Patients with Venous Thromboembolism during Hospitalization for COVID-19
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DOI：
10.1055/s-0040-1718402
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发表时间：
2020-10-21
影响因子：
5.7
通讯作者：
Monreal, Manuel
中科院分区：
文献类型：
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作者：
Fernandez-Capitan, Carmen;Barba, Raquel;Monreal, Manuel
静脉血栓栓塞 (VTE) 在 2019 年冠状病毒病 (COVID-19) 患者中很常见。然而，关于患者特征、治疗和结果的数据有限。描述因 COVID-19 住院期间诊断为 VTE 的患者的临床特征、治疗模式和短期结果。这是一项针对因 COVID-19 住院期间发生 VTE 的患者进行的前瞻性多国研究。数据来自 Registro Informatizado de la Enfermedad TroomboEmbolica (RIETE) 注册表。分别对医院病房和重症监护病房 (ICU) 患者的全因死亡率、VTE 复发和前 10 天内大出血进行了调查。截至2020年5月3日，共有455名患者在住院期间被诊断出VTE（83%为肺栓塞，17%为孤立性深静脉血栓）； 71%为男性，中位年龄为65岁（四分位距，55-74）岁。大多数患者 (68%) 在内科病房住院，其中 145 人在 ICU 住院。 317 名（88%；95% 置信区间 [CI]：84-91%）患者在 VTE 诊断时正在接受血栓预防。大多数患者 (88%) 接受低分子肝素治疗，15 名患者 (3.6%) 接受再灌注治疗。在 420 名完成 10 天随访的患者中，51 名（12%；95% CI：9.3-15%）死亡，无患者复发，12 名（2.9%；95% CI：1.6-4.8%）经历大出血。医院病房患者的 10 天死亡率为 9.1%（95% CI：6.1-13%），ICU 患者的 10 天死亡率为 19%（95% CI：13-26%）。本研究提供了因 COVID-19 住院期间诊断为急性 VTE 的患者的特征和早期结果。需要进行更多研究来确定预防 VTE 并减轻相关不良后果的最佳策略。
Venous thromboembolism (VTE) is common in patients with coronavirus disease-2019 (COVID-19). However, limited data exist on patient characteristics, treatments, and outcomes. To describe the clinical characteristics, treatment patterns, and short-term outcomes of patients diagnosed with VTE during hospitalization for COVID-19. This is a prospective multinational study of patients with incident VTE during the course of hospitalization for COVID-19. Data were obtained from the Registro Informatizado de la Enfermedad TromboEmbolica (RIETE) registry. All-cause mortality, VTE recurrences, and major bleeding during the first 10 days were separately investigated for patients in hospital wards versus those in intensive care units (ICUs). As of May 03, 2020, a total number of 455 patients were diagnosed with VTE (83% pulmonary embolism, 17% isolated deep vein thrombosis) during their hospital stay; 71% were male, the median age was 65 (interquartile range, 55-74) years. Most patients (68%) were hospitalized in medical wards, and 145 in ICUs. Three hundred and seventeen (88%; 95% confidence interval [CI]: 84-91%) patients were receiving thromboprophylaxis at the time of VTE diagnosis. Most patients (88%) received therapeutic low-molecular-weight heparin, and 15 (3.6%) received reperfusion therapies. Among 420 patients with complete 10-day follow-up, 51 (12%; 95% CI: 9.3-15%) died, no patient recurred, and 12 (2.9%; 95% CI: 1.6-4.8%) experienced major bleeding. The 10-day mortality rate was 9.1% (95% CI: 6.1-13%) among patients in hospital wards and 19% (95% CI: 13-26%) among those in ICUs. This study provides characteristics and early outcomes of patients diagnosed with acute VTE during hospitalization for COVID-19. Additional studies are needed to identify the optimal strategies to prevent VTE and to mitigate adverse outcomes associated.