Worth Heidi, Helmlinger Kasey, Raj Renju, Heidel Eric, Lands Ronald
21823University of Tennessee Medical Center, Knoxville, TN, USA.
Clin Appl Thromb Hemost. 2021 Jan-Dec;27:10760296211053315. doi: 10.1177/10760296211053315.
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.
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。