COVID-19 住院患者不良事件的早期发生与抗凝的有益作用。
Early Occurrence of Adverse Events in Hospitalized Patients With COVID-19 and Beneficial Effect of Anticoagulation.
机构信息
3 Third Department of Medicine, National and Kapodistrian University of Athens, School of Medicine, Sotiria Hospital, Athens, Greece.
3 Third Department of Medicine, National and Kapodistrian University of Athens, School of Medicine, Sotiria Hospital, Athens, Greece;
出版信息
In Vivo. 2022 Jan-Feb;36(1):381-383. doi: 10.21873/invivo.12714.
BACKGROUND/AIM: This study analyzed the characteristics of patients with COVID-19 with major events during the first days of hospitalization.
PATIENTS AND METHODS
This is a retrospective analysis of prospectively collected data from consecutive patients admitted to two hospitals in Athens, Greece. The characteristics of patients with COVID-19 who suffered the primary endpoint (venous thromboembolic events, intubation, and death) during the first days of hospitalization were analyzed.
RESULTS
Among 95 patients included in the analysis, 21 presented with major adverse events during a median follow-up of 13 days. More than 50% of these patients presented with a major event during the first 3 days. Anticoagulation treatment was inversely associated with the cumulative incidence of the primary endpoint [hazard ratio=0.16 (95% confidence interval=0.06-0.47)]. Patients with major events were older, with lower baseline SatO, and higher number of Wells' criteria and Charlson comorbidity index. Among these patients, those with hypertension were at higher risk for early occurrence of events (≤ first three days of hospitalization).
CONCLUSION
Major adverse events may occur early in hospitalized patients with COVID-19 with a high-risk profile. Anticoagulation treatment appears to reduce this risk and thus prompt thromboprophylaxis should be employed in these patients.
背景/目的：本研究分析了 COVID-19 患者在住院初期发生重大事件的特征。
患者和方法
这是对连续入住希腊雅典两家医院的患者前瞻性收集数据的回顾性分析。分析了 COVID-19 患者在住院初期发生主要终点（静脉血栓栓塞事件、插管和死亡）的特征。
结果
在纳入分析的 95 名患者中，21 名患者在中位随访 13 天内出现重大不良事件。这些患者中超过 50%在最初 3 天内出现重大事件。抗凝治疗与主要终点的累积发生率呈负相关[风险比=0.16（95%置信区间=0.06-0.47)]。发生重大事件的患者年龄较大，基线 SatO 较低，Wells 标准和 Charlson 合并症指数较高。在这些患者中，高血压患者发生事件的风险更高（≤住院前三天）。
结论
高危 COVID-19 住院患者可能会早期发生重大不良事件。抗凝治疗似乎降低了这种风险，因此应在这些患者中采用血栓预防措施。
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