Singh Bhupinder, Dhooria Harmeet P, Mohan Bishav, Goyal Abhishek, Singh Gurbhej, Singh Parampratap, Goyal Mayur, Luthra Suraj, Chhabra Shibba T, Tandon Rohit, Aslam Naved, Wander Gurpreet S
Department of Cardiology, All India Institute of Medical Sciences, Bathinda, India -
Department of Medicine, Dayanand Medical College and Hospital, Tagore Nagar, India.
Int Angiol. 2022 Aug;41(4):356-363. doi: 10.23736/S0392-9590.22.04845-3. Epub 2022 Apr 4.
Coronavirus disease-2019 (COVID-19) infection and thrombosis are of great clinical importance as this association has shown to increase mortality. We intend to estimate the incidence of thrombotic events (TE) and their impact on clinical outcomes in hospitalized COVID-19 patients.
This was an analytical cross-sectional study. The study population comprised of hospitalized COVID-19 patients between 1 March 2021 and 31 May 2021. The clinico-demographic data, thrombotic events, and clinical outcomes were collected from electronic health records.
A total of 1274 patients were analyzed. The median age of the study population was 56 years (IQR: 44-66 years). The estimated incidence of TE was 5.8% (N.=74); 60.8% of these TE occurred in patients having severe/critical COVID-19 illness and 70.3% of TE occurred in patients in the intensive care unit. Venous events (3.9%) were common compared to arterial events(1.9%). On multivariate logistic regression analysis, total leukocyte count, C-reactive protein, and D-dimer level were found to be the independent predictors of having TE. Receiver operator curve revealed a cut-off point of 872.5 DDU µg/L for D-dimer level (sensitivity: 67.6% and specificity: 72.1%; P<0.001, area under curve 0.78) for predicting TE. Patients with TE had significantly higher mortality compared to those without TE (58.1% vs. 22.2%; P<0.001); and the presence of TE (OR=2.94; 95% CI:1.7-5.1, P<0.001) was found to be the independent predictor of mortality.
The incidence of TE is high for hospitalized COVID-19 patients and it is even higher in severe/critical COVID illness. Its presence has shown to double the mortality compared to those without it.
2019年冠状病毒病（COVID-19）感染与血栓形成具有重大临床意义，因为这种关联已显示会增加死亡率。我们旨在估计住院COVID-19患者血栓形成事件（TE）的发生率及其对临床结局的影响。
这是一项分析性横断面研究。研究人群包括2021年3月1日至2021年5月31日期间住院的COVID-19患者。临床人口统计学数据、血栓形成事件和临床结局从电子健康记录中收集。
共分析了1274例患者。研究人群的中位年龄为56岁（四分位间距：44 - 66岁）。TE的估计发生率为5.8%（n = 74）；其中60.8%的TE发生在患有重度/危重型COVID-19疾病的患者中，70.3%的TE发生在重症监护病房的患者中。与动脉事件（1.9%）相比，静脉事件（3.9%）更为常见。多因素逻辑回归分析发现，总白细胞计数、C反应蛋白和D-二聚体水平是发生TE的独立预测因素。受试者工作特征曲线显示，D-二聚体水平预测TE的截断点为872.5 DDU µg/L（敏感性：67.6%，特异性：72.1%；P<0.001，曲线下面积0.78）。与无TE的患者相比，有TE的患者死亡率显著更高（58.1%对22.2%；P<0.001）；并且发现TE的存在（比值比=2.94；95%置信区间：1.7 - 5.1，P<0.001）是死亡率的独立预测因素。
住院COVID-19患者TE的发生率很高，在重度/危重型COVID疾病中甚至更高。与没有TE 的患者相比，其存在已显示死亡率会增加一倍。
