Postdischarge thrombosis and hemorrhage in patients with COVID-19
Postdischarge thrombosis and hemorrhage in patients with COVID-19
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DOI：
10.1182/blood.2020007938
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发表时间：
2020-09-10
期刊：
影响因子：
20.3
通讯作者：
Zwicker, Jeffrey, I
中科院分区：
文献类型：
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作者：
Patell, Rushad;Bogue, Thomas;Zwicker, Jeffrey, I
2019 冠状病毒病 (COVID-19) 与血栓前状态相关，住院期间血栓事件发生率很高；然而，检查出院后血栓形成率的数据有限。我们对已确诊的 COVID-19 未接受抗凝治疗的出院患者进行了一项回顾性观察队列研究。该队列包括 163 名患者，从出院到最后一次记录随访的中位时间为 30 天（四分位数范围 DORI，17-46 天）。指数住院时间中位数为 6 天（IQR，3-12 天），26% 需要重症监护。出院后第 30 天血栓形成（包括动脉和静脉事件）的累积发生率为 2.5%（95% 置信区间 [CI]，0.8-7.6）；出院后第 30 天单独静脉血栓栓塞的累积发生率为 0.6%（95% CI，0.1-4.6）。大出血的 30 天累积发生率为 0.7%（95% CI，0.1-5.1），临床相关非大出血的 30 天累积发生率为 2.9%（95% CI，1.0-9.1）。我们的结论是，因 COVID-19 出院后血栓形成和出血的发生率似乎相似，强调需要随机数据来为出院后普遍预防血栓的建议提供信息。
Coronavirus disease 2019 (COVID-19) is associated with a prothrombotic state with a high incidence of thrombotic events during hospitalization; however, data examining rates of thrombosis after discharge are limited. We conducted a retrospective observational cohort study of discharged patients with confirmed COVID-19 not receiving anticoagulation. The cohort included 163 patients with median time from discharge to last recorded follow up of 30 days (interquartile range DORI, 17-46 days). The median duration of index hospitalization was 6 days (IQR, 3-12 days) and 26% required intensive care. The cumulative incidence of thrombosis (including arterial and venous events) at day 30 following discharge was 2.5% (95% confidence interval [CI], 0.8-7.6); the cumulative incidence of venous thromboembolism alone at day 30 postdischarge was 0.6% (95% CI, 0.1-4.6). The 30-day cumulative incidence of major hemorrhage was 0.7% (95% CI, 0.1-5.1) and of clinically relevant nonmajor bleeds was 2.9% (95% CI, 1.0-9.1). We conclude that the rates of thrombosis and hemorrhage appear to be similar following hospital discharge for COVID-19, emphasizing the need for randomized data to inform recommendations for universal postdischarge thromboprophylaxis.