From the Department of Vascular Surgery, Yichang Central People's Hospital, The First College of Clinical Medical Science, China Three Gorges University, Hubei (F.M., J.F., J.Y., K.W., J.S., W.G., M.H., Y.L.).
National Health Commission Key Lab of Radiobiology, Jilin University, Changchun, Jilin, China (Z.L.).
Arterioscler Thromb Vasc Biol. 2020 Sep;40(9):2332-2337. doi: 10.1161/ATVBAHA.120.314779. Epub 2020 Jul 6.
The objectives were to investigate and compare the risks and incidences of venous thromboembolism (VTE) between the 2 groups of patients with coronavirus disease 2019 (COVID-19) pneumonia and community-acquired pneumonia (CAP). Approach and Results: Medical records of 616 pneumonia patients who were admitted to the Yichang Central People's Hospital in Hubei, China, from January 1 to March 23, 2020, were retrospectively reviewed. The patients with COVID-19 pneumonia were treated in the dedicated COVID-19 units, and the patients with CAP were admitted to regular hospital campus. Risks of VTE were assessed using the Padua prediction score. All the patients received pharmaceutical or mechanical VTE prophylaxis. VTE was diagnosed using Duplex ultrasound or computed tomography pulmonary angiogram. Differences between COVID-19 and CAP groups were compared statistically. All statistical tests were 2 sided, and <0.05 was considered as statistically significant. All data managements and analyses were performed by IBM SPSS, version 24, software (SPSS, Inc, Chicago, IL). Of the 616 patients, 256 had COVID-19 pneumonia and 360 patients had CAP. The overall rate of VTE was 2% in COVID-19 pneumonia group and 3.6% in CAP group, respectively (=0.229). In these two groups, 15.6% of the COVID-19 pneumonia patients and 10% of the CAP patients were categorized as high risk for VTE (Padua score, >4), which were significantly different (=0.036). In those high-risk patients, the incidence of VTE was 12.5% in COVID-19 pneumonia group and 16.7% in CAP group (=0.606). Subgroup analysis of the critically ill patients showed that VTE rate was 6.7% in COVID-19 group versus 13% in CAP group (=0.484). In-hospital mortality of COVID-19 and CAP was 6.3% and 3.9%, respectively (=0.180).
Our study suggested that COVID-19 pneumonia was associated with hypercoagulable state. However, the rate of VTE in COVID-19 pneumonia patients was not significantly higher than that in CAP patients.
本研究旨在调查和比较 2019 年冠状病毒病(COVID-19)肺炎和社区获得性肺炎(CAP)患者的静脉血栓栓塞(VTE)风险和发生率。
回顾性分析 2020 年 1 月 1 日至 3 月 23 日期间,来自中国湖北省宜昌市中心人民医院的 616 例肺炎患者的病历。COVID-19 肺炎患者在专门的 COVID-19 病房接受治疗,CAP 患者则入住常规医院院区。使用帕多瓦预测评分评估 VTE 风险。所有患者均接受药物或机械性 VTE 预防。通过双能超声或计算机断层肺动脉造影诊断 VTE。比较 COVID-19 组和 CAP 组之间的差异。所有统计检验均为双侧,P<0.05 认为有统计学意义。所有数据管理和分析均采用 IBM SPSS 版本 24 软件(SPSS,Inc,芝加哥,IL)进行。616 例患者中,256 例为 COVID-19 肺炎,360 例为 CAP。COVID-19 肺炎组和 CAP 组的总体 VTE 发生率分别为 2%和 3.6%(=0.229)。在这两组中,COVID-19 肺炎患者中有 15.6%和 CAP 患者中有 10%的患者 VTE 风险高(Padua 评分>4),差异有统计学意义(=0.036)。在这些高危患者中,COVID-19 肺炎组的 VTE 发生率为 12.5%,CAP 组为 16.7%(=0.606)。危重症患者亚组分析显示,COVID-19 组 VTE 发生率为 6.7%,CAP 组为 13%(=0.484)。COVID-19 和 CAP 的住院死亡率分别为 6.3%和 3.9%(=0.180)。
本研究提示 COVID-19 肺炎与高凝状态相关。然而,COVID-19 肺炎患者的 VTE 发生率并未显著高于 CAP 患者。