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法国住院 COVID-19 患者静脉血栓栓塞症的一年患病率:患者特征、时间趋势和结局。

One Year Prevalence of Venous Thromboembolism in Hospitalized COVID-19 Patients in France: Patients' Characteristics, Time Trends, and Outcomes.

机构信息

Cardiovascular Division, Department of Non-Communicable Diseases, Santé Publique France, Saint-Maurice (94), France.

Department of Studies Strategy and Statistics, Caisse Nationale d'Assurance Maladie, Paris, France.

出版信息

Thromb Haemost. 2022 Sep;122(9):1532-1541. doi: 10.1055/s-0042-1743475. Epub 2022 Mar 14.

Abstract

BACKGROUND

Patients hospitalized with coronavirus disease-2019 (COVID-19) are at high risk of deep venous thrombosis (DVT) and pulmonary embolism (PE).

OBJECTIVES

The aims were to provide time trends in the 2020 nation-wide prevalence of venous thromboembolism (VTE) in patients hospitalized with a COVID-19 diagnosis in France, and to describe in-hospital and up to 30-day postdischarge death.

METHODS

All patients hospitalized in France with a COVID-19 diagnosis in 2020 were selected. Crude and age-adjusted prevalence of VTE and PE was computed by 4-week intervals and for the overall study period using Poisson regression. Time trends in in-hospital and 30-day postdischarge case-fatality rates were evaluated by comparing each 4-week intervals to weeks 10 to 14 corresponding to the first part of the first lockdown using logistic regression models.

RESULTS

Among the 287,638 patients hospitalized with a COVID-19 diagnosis in 2020 in France, 14,985 (5.2%) had a concomitant VTE, with 10,453 (3.6%) having PE and 4,532 (1.6%) having DVT. In patients admitted to intensive care units, the crude prevalence of VTE and PE reached 16.1 and 11.0% respectively during the first lockdown. After adjustment, the prevalence of VTE and PE decreased during the year 2020 but a rebound was observed during the second lockdown. In-hospital case-fatality rates among hospitalized COVID-19 patients with PE globally decreased between the first and the second epidemic waves.

CONCLUSION

Our study showed a decrease in the incidence of symptomatic VTE and PE in hospitalized COVID-19 patients, and a decreased time trend of outcomes during the second wave compared with the first one.

摘要

背景

患有 2019 年冠状病毒病(COVID-19)的住院患者有发生深静脉血栓(DVT)和肺栓塞(PE)的高风险。

目的

本研究旨在提供法国 COVID-19 住院患者 2020 年静脉血栓栓塞症(VTE)的全国患病率的时间趋势,并描述住院期间和出院后 30 天内的死亡情况。

方法

选择 2020 年在法国住院且诊断为 COVID-19 的所有患者。使用泊松回归计算 4 周间隔和整个研究期间的 VTE 和 PE 的粗患病率和年龄调整患病率。使用逻辑回归模型,通过比较每个 4 周间隔与第 10 周至 14 周(对应于第一次封锁的第一部分),评估住院期间和出院后 30 天内的病死率的时间趋势。

结果

2020 年在法国住院且诊断为 COVID-19 的 287638 例患者中,有 14985 例(5.2%)同时患有 VTE,其中 10453 例(3.6%)患有 PE,4532 例(1.6%)患有 DVT。在入住重症监护病房的患者中,在第一次封锁期间,VTE 和 PE 的粗患病率分别达到 16.1%和 11.0%。调整后,2020 年 VTE 和 PE 的患病率下降,但在第二次封锁期间出现反弹。COVID-19 合并 PE 的住院患者的院内病死率在第一次和第二次流行浪潮之间全球呈下降趋势。

结论

本研究显示,住院 COVID-19 患者中症状性 VTE 和 PE 的发病率下降,与第一次流行相比,第二次流行的结局呈下降趋势。

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