Leiva Orly, Campia Umberto, Snyder Julia, Barns Briana M, Rizzo Samantha, Khairani Candrika D, Brunner Andrew, Al-Samkari Hanny, Leaf Rebecca Karp, Rosovsky Rachel, Goodarzi Katayoon, Bornikova Larissa, Fathi Amir, Goldhaber Samuel Z, Hobbs Gabriela, Piazza Gregory
Division of Cardiovascular Medicine, Department of Medicine New York University Langone Health New York City New York USA.
Department of Medicine Brigham and Women's Hospital and Harvard Medical School Boston Massachusetts USA.
Res Pract Thromb Haemost. 2022 Aug 11;6(5):e12752. doi: 10.1002/rth2.12752. eCollection 2022 Jul.
Both coronavirus disease-2019 (COVID-19) and myeloproliferative neoplasms (MPNs) are associated with systemic inflammation and risk of thrombosis. Risk of thrombosis in patients with COVID with and without MPNs has not been extensively studied.
Retrospective cohort study of 44 patients with MPNs and 1114 patients without MPNs positive for SARS-COV-2. Outcomes were arterial thrombosis (AT), venous thromboembolism (VTE), bleeding, and death. Time-to-event analysis was performed using competing risk regression model and Cox proportional hazards.
AT occurred more frequently in patients with MPN (7% vs. 1%, = 0.03). Rates of VTE (7% vs. 5%, = 0.73), bleeding (7% vs. 2%, = 0.06), and death (9% vs. 6%, = 0.32) were similar. MPN patients were older and had more cardiovascular comorbidities. After time-to-event competing-risk regression adjusting for age, MPN patients had higher risk of AT (subdivision hazards ratio 3.95, 95% CI 1.09-14.39) but not VTE, bleeding, or death.
Among patients with COVID-19, MPN patients had higher risk of arterial thrombosis but not VTE, bleeding, and death compared with non-MPN patients. Larger studies are needed to confirm our findings given the limited sample size.
2019冠状病毒病（COVID-19）和骨髓增殖性肿瘤（MPN）均与全身炎症和血栓形成风险相关。合并或未合并MPN的COVID患者的血栓形成风险尚未得到广泛研究。
对44例MPN患者和1114例SARS-CoV-2检测呈阳性的非MPN患者进行回顾性队列研究。观察指标为动脉血栓形成（AT）、静脉血栓栓塞（VTE）、出血和死亡。采用竞争风险回归模型和Cox比例风险模型进行事件发生时间分析。
MPN患者中AT的发生频率更高（7%对1%，P = 0.03）。VTE（7%对5%，P = 0.73）、出血（7%对2%，P = 0.06）和死亡（9%对6%，P = 0.32）的发生率相似。MPN患者年龄更大，心血管合并症更多。在对年龄进行事件发生时间竞争风险回归调整后，MPN患者发生AT的风险更高（亚组风险比3.95，95%可信区间1.09 - 14.39），但VTE、出血或死亡风险未增加。
在COVID-19患者中，与非MPN患者相比，MPN患者发生动脉血栓形成的风险更高，但VTE、出血和死亡风险未增加。鉴于样本量有限，需要更大规模的研究来证实我们的发现。
