Section of Vascular Surgery, Heart and Vascular Center Dartmouth-Hitchcock Medical Center Lebanon NH.
Section of Cardiovascular Medicine, Heart and Vascular Center Dartmouth-Hitchcock Medical Center Lebanon NH.
J Am Heart Assoc. 2021 Dec 7;10(23):e022829. doi: 10.1161/JAHA.121.022829. Epub 2021 Nov 30.
Background Patients hospitalized with COVID-19 have an increased risk of thromboembolic events. Whether sex, race or ethnicity impacts these events is unknown. We studied the association between sex, race, and ethnicity and venous and arterial thromboembolic events among adults hospitalized with COVID-19. Methods and Results We used the American Heart Association Cardiovascular Disease COVID-19 registry. Primary exposures were sex and race and ethnicity, as defined by the registry. Primary outcomes were venous thromboembolic events and arterial thromboembolic events. We used logistic regression for risk adjustment. We studied 21 528 adults hospitalized with COVID-19 across 107 centers (54.1% men; 38.1% non-Hispanic White, 25.4% Hispanic, 25.7% non-Hispanic Black, 0.5% Native American, 4.0% Asian, 0.4% Pacific Islander, and 5.9% other race and ethnicity). The rate of venous thromboembolic events was 3.7% and was more common in men (4.2%) than women (3.2%; <0.001), and in non-Hispanic Black patients (4.9%) than other races and ethnicities (range, 1.3%-3.8%; <0.001). The rate of arterial thromboembolic events was 3.9% and was more common in men (4.3%) than women (3.5%; =0.002), and in non-Hispanic Black patients (5.0%) than other races and ethnicities (range, 2.3%-4.7%; <0.001). Compared with men, women were less likely to experience venous thromboembolic events (adjusted odds ratio [OR], 0.71; 95% CI, 0.61-0.83) and arterial thromboembolic events (adjusted OR, 0.76; 95% CI, 0.66-0.89). Compared with non-Hispanic White patients, non-Hispanic Black patients had the highest likelihood of venous thromboembolic events (adjusted OR, 1.27; 95% CI, 1.04-1.54) and arterial thromboembolic events (adjusted OR, 1.35; 95% CI, 1.11-1.65). Conclusions Men and non-Hispanic Black adults hospitalized with COVID-19 are more likely to have venous and arterial thromboembolic events. These subgroups may represent at-risk patients more susceptible to thromboembolic COVID-19 complications.
背景 患有 COVID-19 的住院患者发生血栓栓塞事件的风险增加。性别、种族或民族是否会影响这些事件尚不清楚。我们研究了成年 COVID-19 住院患者中性别、种族和民族与静脉和动脉血栓栓塞事件之间的关系。
方法和结果 我们使用了美国心脏协会心血管疾病 COVID-19 注册中心的数据。主要暴露因素是性别和种族和民族，由注册中心定义。主要结局是静脉血栓栓塞事件和动脉血栓栓塞事件。我们使用逻辑回归进行风险调整。我们研究了来自 107 个中心的 21528 名患有 COVID-19 的成年患者（54.1%为男性；38.1%为非西班牙裔白人，25.4%为西班牙裔，25.7%为非西班牙裔黑人，0.5%为美洲原住民，4.0%为亚洲人，0.4%为太平洋岛民，5.9%为其他种族和民族）。静脉血栓栓塞事件的发生率为 3.7%，男性（4.2%）比女性（3.2%）更常见（<0.001），非西班牙裔黑人患者（4.9%）比其他种族和民族更常见（范围为 1.3%-3.8%）（<0.001）。动脉血栓栓塞事件的发生率为 3.9%，男性（4.3%）比女性（3.5%）更常见（=0.002），非西班牙裔黑人患者（5.0%）比其他种族和民族更常见（范围为 2.3%-4.7%）（<0.001）。与男性相比，女性发生静脉血栓栓塞事件的可能性较小（调整后的优势比[OR]，0.71；95%CI，0.61-0.83）和动脉血栓栓塞事件（调整后的 OR，0.76；95%CI，0.66-0.89）。与非西班牙裔白人患者相比，非西班牙裔黑人患者发生静脉血栓栓塞事件（调整后的 OR，1.27；95%CI，1.04-1.54）和动脉血栓栓塞事件（调整后的 OR，1.35；95%CI，1.11-1.65）的可能性最高。
结论 患有 COVID-19 的住院男性和非西班牙裔黑人成年人更有可能发生静脉和动脉血栓栓塞事件。这些亚组可能代表更容易发生 COVID-19 血栓栓塞并发症的高危患者。
