Stals Milou A M, Grootenboers Marco J J H, van Guldener Coen, Kaptein Fleur H J, Braken Sander J E, Chen Qingui, Chu Gordon, van Driel Erik M, Iglesias Del Sol Antonio, de Jonge Evert, Kant K Merijn, Pals Fleur, Toorop Myrthe M A, Cannegieter Suzanne C, Klok Frederikus A, Huisman Menno V
Department of Thrombosis and Hemostasis Leiden University Medical Center Leiden The Netherlands.
Department of Pulmonology Amphia Hospital Breda The Netherlands.
Res Pract Thromb Haemost. 2021 Apr 8;5(3):412-420. doi: 10.1002/rth2.12496. eCollection 2021 Mar.
Whereas accumulating studies on patients with coronavirus disease 2019 (COVID-19) report high incidences of thrombotic complications, large studies on clinically relevant thrombosis in patients with other respiratory tract infections are lacking. How this high risk in COVID-19 patients compares to those observed in hospitalized patients with other viral pneumonias such as influenza is unknown.
To assess the incidence of venous and arterial thrombotic complications in hospitalized patients with influenza as opposed to that observed in hospitalized patients with COVID-19.
This was a retrospective cohort study; we used data from Statistics Netherlands (study period: 2018) on thrombotic complications in hospitalized patients with influenza. In parallel, we assessed the cumulative incidence of thrombotic complications-adjusted for competing risk of death-in patients with COVID-19 in three Dutch hospitals (February 24 to April 26, 2020).
Of the 13 217 hospitalized patients with influenza, 437 (3.3%) were diagnosed with thrombotic complications, versus 66 (11%) of the 579 hospitalized patients with COVID-19. The 30-day cumulative incidence of any thrombotic complication in influenza was 11% (95% confidence interval [CI], 9.4-12) versus 25% (95% CI, 18-32) in COVID-19. For venous thrombotic (VTC) complications and arterial thrombotic complications alone, these numbers were, respectively, 3.6% (95% CI, 2.7-4.6) and 7.5% (95% CI, 6.3-8.8) in influenza versus 23% (95% CI, 16-29) and 4.4% (95% CI, 1.9-8.8) in COVID-19.
The incidence of thrombotic complications in hospitalized patients with influenza was lower than in hospitalized patients with COVID-19. This difference was mainly driven by a high risk of VTC complications in the patients with COVID-19 admitted to the Intensive Care Unit. Remarkably, patients with influenza were more often diagnosed with arterial thrombotic complications.
尽管关于2019冠状病毒病（COVID-19）患者的研究不断积累，报告显示血栓形成并发症的发生率很高，但缺乏针对其他呼吸道感染患者临床相关血栓形成的大型研究。COVID-19患者的这种高风险与其他病毒性肺炎（如流感）住院患者的情况相比如何尚不清楚。
评估流感住院患者与COVID-19住院患者静脉和动脉血栓形成并发症的发生率。
这是一项回顾性队列研究；我们使用了荷兰统计局（研究期间：2018年）关于流感住院患者血栓形成并发症的数据。同时，我们评估了荷兰三家医院COVID-19患者（2020年2月24日至4月26日）经死亡竞争风险调整后的血栓形成并发症累积发生率。
13217例流感住院患者中，437例（3.3%）被诊断为血栓形成并发症，而579例COVID-19住院患者中有66例（11%）。流感患者任何血栓形成并发症的30天累积发生率为11%（95%置信区间[CI]，9.4-12），而COVID-19患者为25%（95%CI，18-32）。仅就静脉血栓形成（VTC）并发症和动脉血栓形成并发症而言，流感患者的这些数字分别为3.6%（95%CI，2.7-4.6）和7.5%（95%CI，6.3-8.8），而COVID-19患者分别为23%（95%CI，16-29）和4.4%（9%CI，1.9-8.8）。
流感住院患者血栓形成并发症的发生率低于COVID-19住院患者。这种差异主要是由入住重症监护病房的COVID-19患者VTC并发症的高风险驱动的。值得注意的是，流感患者更常被诊断为动脉血栓形成并发症。
