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日本住院的 2019 冠状病毒病(COVID-19)患者中静脉血栓栓塞症的发生率和临床特征。

Incidence and Clinical Features of Venous Thromboembolism in Hospitalized Patients With Coronavirus Disease 2019 (COVID-19) in Japan.

机构信息

Kyoto University Hospital.

Aichi Medical University Hospital.

出版信息

Circ J. 2021 Nov 25;85(12):2208-2214. doi: 10.1253/circj.CJ-21-0169. Epub 2021 May 20.

Abstract

BACKGROUND

Coronavirus disease 2019 (COVID-19) reportedly causes venous thromboembolism (VTE), but the status of this complication in Japan was unclear.

METHODS AND RESULTS

The VTE and COVID-19 in Japan Study is a retrospective, multicenter cohort study enrolling hospitalized patients with COVID-19 who were evaluated with contrast-enhanced computed tomography (CT) examination at 22 centers in Japan between March 2020 and October 2020. Among 1,236 patients with COVID-19, 45 (3.6%) were evaluated with contrast-enhanced CT examination. VTE events occurred in 10 patients (22.2%), and the incidence of VTE in mild, moderate, and severe COVID-19 was 0%, 11.8%, and 40.0%, respectively. COVID-19 patients with VTE showed a higher body weight (81.6 vs. 64.0 kg, P=0.005) and body mass index (26.9 vs. 23.2 kg/m, P=0.04), and a higher proportion had a severe status for COVID-19 compared with those without. There was no significant difference in the proportion of patients alive at discharge between patients with and without VTE (80.0% vs. 88.6%, P=0.48). Among 8 pulmonary embolism (PE) patients, all were low-risk PE.

CONCLUSIONS

Among a relatively small number of patients undergoing contrast-enhanced CT examination in Japanese real-world clinical practice, there were no VTE patients among those with mild COVID-19, but the incidence of VTE seemed to be relatively high among severe COVID-19 patients, although all PE events were low-risk without significant effect on mortality risk.

摘要

背景

据报道,2019 年冠状病毒病(COVID-19)可导致静脉血栓栓塞症(VTE),但日本对此并发症的情况尚不清楚。

方法和结果

日本 COVID-19 中的 VTE 研究是一项回顾性、多中心队列研究,纳入了 2020 年 3 月至 10 月期间在日本 22 个中心因 COVID-19 住院并接受增强 CT 检查的患者。在 1236 例 COVID-19 患者中,有 45 例(3.6%)接受了增强 CT 检查。10 例(22.2%)发生 VTE 事件,轻症、中度和重症 COVID-19 患者的 VTE 发生率分别为 0%、11.8%和 40.0%。患有 VTE 的 COVID-19 患者体重(81.6 与 64.0kg,P=0.005)和 BMI(26.9 与 23.2kg/m,P=0.04)更高,且 COVID-19 严重程度更高。有 VTE 与无 VTE 的患者出院时的存活率差异无统计学意义(80.0%与 88.6%,P=0.48)。8 例肺栓塞(PE)患者均为低危 PE。

结论

在日本真实世界临床实践中,接受增强 CT 检查的患者人数相对较少,轻症 COVID-19 患者中无 VTE 患者,但重症 COVID-19 患者的 VTE 发生率似乎相对较高,尽管所有的 PE 事件均为低危,对死亡率无显著影响。

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