Suppr超能文献

重症监护病房与非重症监护病房的新型冠状病毒 2 型(SARS-CoV-2)感染重症患者的血栓栓塞发生率相似:一项回顾性队列研究

Thromboembolic Rates Are Similar Between Intensive Care Unit and Nonintensive Care Unit Hospitalized Patients With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): A Retrospective Cohort Study.

作者信息

Worth Heidi, Helmlinger Kasey, Raj Renju, Heidel Eric, Lands Ronald

机构信息

21823University of Tennessee Medical Center, Knoxville, TN, USA.

出版信息

Clin Appl Thromb Hemost. 2021 Jan-Dec;27:10760296211053315. doi: 10.1177/10760296211053315.

Abstract

High rates of thromboembolic events have been described in intensive care unit (ICU) patients. Data regarding thromboembolic events in all hospitalized patients has been less frequently reported, raising concerns that thromboembolic events in non-ICU may be underrecognized. In addition, optimal anticoagulation type and dose is still unsettled at this time. This is a retrospective cohort study of 159 hospitalized patients with coronavirus disease 2019 (COVID-19) pneumonia during a 9-month period to determine an association between the frequency of thromboembolic rates and hospitalized patients with COVID-19. Secondary outcomes sought to investigate association of thromboembolic events with relation to place of admission, risk factors, anticoagulation, mortality, hospital length of stay, and discharge disposition. Among the cohort of 159 hospitalized patients who met criteria, 16 (10%) were diagnosed with a thromboembolic event. There were a total of 18 thromboembolic events with 12 venous and 6 arterial. Admission to the ICU was not associated with a higher frequency of thromboembolic events compared with non-ICU patients (37.5% vs 62.5%),  = .71. Patients with a thromboembolic event had a significantly higher mortality compared with those with no thromboembolic event (37.5% vs 13.3%),  = .012. Patients hospitalized with COVID-19 have increased rates of thromboembolic events, both venous and arterial, which contribute to a significant increase in mortality. However, the frequency of thromboembolism in patients admitted to the ICU was similar to events in non-ICU patients. We hope to increase awareness of the increased risk of hypercoagulability in all hospitalized patients with COVID-19 including non-ICU patients.

摘要

重症监护病房(ICU)患者中血栓栓塞事件的发生率较高。关于所有住院患者血栓栓塞事件的数据报告较少,这引发了人们对非ICU患者中血栓栓塞事件可能未得到充分认识的担忧。此外,目前最佳的抗凝类型和剂量仍未确定。这是一项回顾性队列研究,研究对象为159例在9个月期间因2019冠状病毒病(COVID-19)肺炎住院的患者,旨在确定血栓栓塞发生率与COVID-19住院患者之间的关联。次要结局旨在调查血栓栓塞事件与入院地点、危险因素、抗凝、死亡率、住院时间和出院处置之间的关联。在符合标准的159例住院患者队列中,16例(10%)被诊断为血栓栓塞事件。共有18次血栓栓塞事件,其中12次为静脉血栓栓塞,6次为动脉血栓栓塞。与非ICU患者相比,入住ICU与血栓栓塞事件的发生率较高无关(37.5%对62.5%),P = 0.71。发生血栓栓塞事件的患者死亡率显著高于未发生血栓栓塞事件的患者(37.5%对13.3%),P = 0.012。COVID-19住院患者的静脉和动脉血栓栓塞事件发生率均有所增加,这导致死亡率显著上升。然而,入住ICU患者的血栓栓塞发生率与非ICU患者相似。我们希望提高对所有COVID-19住院患者(包括非ICU患者)高凝风险增加的认识。

相似文献

2
Registry of Arterial and Venous Thromboembolic Complications in Patients With COVID-19.
J Am Coll Cardiol. 2020 Nov 3;76(18):2060-2072. doi: 10.1016/j.jacc.2020.08.070.
3
Early experience with arterial thromboembolic complications in patients with COVID-19.
J Vasc Surg. 2021 Feb;73(2):381-389.e1. doi: 10.1016/j.jvs.2020.07.089. Epub 2020 Aug 28.
4
Thromboembolic Events and Role of Point of Care Ultrasound in Hospitalized Covid-19 Patients Needing Intensive Care Unit Admission.
J Intensive Care Med. 2021 Dec;36(12):1483-1490. doi: 10.1177/0885066620964392. Epub 2020 Oct 6.
5
Deep vein thrombosis in hospitalized patients with coronavirus disease 2019.
J Vasc Surg Venous Lymphat Disord. 2021 May;9(3):597-604. doi: 10.1016/j.jvsv.2020.09.010. Epub 2020 Oct 8.
9

本文引用的文献

1
COVID-19 is, in the end, an endothelial disease.
Eur Heart J. 2020 Sep 1;41(32):3038-3044. doi: 10.1093/eurheartj/ehaa623.
2
Reduced Vitamin K Status as a Potentially Modifiable Risk Factor of Severe Coronavirus Disease 2019.
Clin Infect Dis. 2021 Dec 6;73(11):e4039-e4046. doi: 10.1093/cid/ciaa1258.
3
Anticoagulation practice patterns in COVID-19: A global survey.
Res Pract Thromb Haemost. 2020 Aug 19;4(6):969-983. doi: 10.1002/rth2.12414. eCollection 2020 Aug.
4
Venous thromboembolism in non-critically ill patients with COVID-19 infection.
Thromb Res. 2020 Sep;193:166-169. doi: 10.1016/j.thromres.2020.07.033. Epub 2020 Jul 17.
5
COVID-19-associated hyperviscosity: a link between inflammation and thrombophilia?
Lancet. 2020 Jun 6;395(10239):1758-1759. doi: 10.1016/S0140-6736(20)31209-5. Epub 2020 May 25.
6
Impact of anticoagulation prior to COVID-19 infection: a propensity score-matched cohort study.
Blood. 2020 Jul 2;136(1):144-147. doi: 10.1182/blood.2020006941.
7
COVID-19: the vasculature unleashed.
Nat Rev Immunol. 2020 Jul;20(7):389-391. doi: 10.1038/s41577-020-0343-0.
8
Association of Treatment Dose Anticoagulation With In-Hospital Survival Among Hospitalized Patients With COVID-19.
J Am Coll Cardiol. 2020 Jul 7;76(1):122-124. doi: 10.1016/j.jacc.2020.05.001. Epub 2020 May 6.
9
Incidence of venous thromboembolism in hospitalized patients with COVID-19.
J Thromb Haemost. 2020 Aug;18(8):1995-2002. doi: 10.1111/jth.14888. Epub 2020 Jul 27.
10
Lupus Anticoagulant and Abnormal Coagulation Tests in Patients with Covid-19.
N Engl J Med. 2020 Jul 16;383(3):288-290. doi: 10.1056/NEJMc2013656. Epub 2020 May 5.

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验