Cardiology Department, Hedi Chaker Hospital, University of Medicine, Sfax University, Sfax, Tunisia.
Epidemiology Department Hedi Chaker Hospital, University of Medicine, Sfax University, Sfax, Tunisia.
PLoS One. 2022 Aug 4;17(8):e0270195. doi: 10.1371/journal.pone.0270195. eCollection 2022.
There are no clear data about the incidence and the prophylactic strategies of arterial and venous thromboembolic events (TE) in COVID-19 ambulatory patients. Thus, we conducted this study to analyze thromboembolic complications in this setting and to assess thromboprophylaxis management and outcomes in the real life.
This is an observational study including Covid-19 ambulatory patients. We assessed incidence of venous and arterial TE events as well as thromboprophylaxis outcomes and hemorrhagic complications. We defined high risk thrombo-embolic factor according to the Belgian guidelines which are the only guidelines that described thromboprophylaxis in COVID-19 ambulatory patients.
We included 2089 patients with a mean age of 43±16 years. The incidence of 30 days venous and arterial TE complications in our cohort was 1%. Venous thromboembolic complications occurred in 0.8% and arterial thromboembolic complications occurred in 0.3%.We noted at least one high-risk TE factor in 18.5% of patients but thromboprophylaxis was prescribed in 22.5% of the cases, LMWH in 18.1%, and Rivaroxaban in 3.7%. Hemorrhagic events occurred in eight patients (0.3%): five patients showed minor hemorrhagic events and three patients showed major ones (0.14%).
Our study showed that the incidence of thromboembolic complications is very low in COVID-19 ambulatory patients. Paradoxically, there is an over prescription of thrombo-prophylaxis in this population.
目前关于 COVID-19 门诊患者动脉和静脉血栓栓塞事件（TE）的发生率和预防策略尚无明确数据。因此，我们进行了这项研究，以分析该人群中的血栓栓塞并发症，并评估真实生活中的血栓预防管理和结局。
这是一项观察性研究，纳入了 COVID-19 门诊患者。我们评估了静脉和动脉 TE 事件的发生率以及血栓预防的结局和出血并发症。我们根据比利时指南定义了高风险血栓栓塞因素，该指南是唯一描述 COVID-19 门诊患者血栓预防的指南。
我们纳入了 2089 例平均年龄为 43±16 岁的患者。在我们的队列中，30 天静脉和动脉 TE 并发症的发生率为 1%。静脉血栓栓塞并发症发生率为 0.8%，动脉血栓栓塞并发症发生率为 0.3%。我们注意到 18.5%的患者至少存在一个高危 TE 因素，但仅 22.5%的患者处方了血栓预防药物，其中低分子肝素占 18.1%，利伐沙班占 3.7%。8 例患者（0.3%）发生出血事件：5 例为轻微出血事件，3 例为严重出血事件（0.14%）。
我们的研究表明，COVID-19 门诊患者的血栓栓塞并发症发生率非常低。但令人费解的是，该人群中血栓预防药物的处方过度。
