Department of Internal Medicine, National Hospital Organization Tochigi Medical Center, Tochigi, Japan.
Medicine (Baltimore). 2022 Aug 19;101(33):e29933. doi: 10.1097/MD.0000000000029933.
A high incidence of thromboembolic complications is one of the hallmarks of COVID-19. However, there may be a difference in the incidence of thromboembolic complications between Asian and Western people. In addition, few prospective studies have been conducted to determine the incidence of thromboembolic complications in hospitalized COVID-19 patients in medical wards in Japan.
A single-center retrospective and prospective cohort study was conducted to determine the incidence of thromboembolic complications in symptomatic COVID-19 patients in a medical ward in a Japanese hospital. All 1116 consecutive COVID-19 patients who were admitted to our hospital from November 1, 2020, to October 26, 2021, were included. The primary outcome was any thromboembolic complications, which included venous thromboembolism, myocardial infarction, ischemic stroke, and other arterial embolisms.
The median patient age was 50 (IQR, 37-61), 402 (36.0%) were women, 1005 (90.1%) were Japanese, the median body mass index was 24.1 (IQR, 21.6-27.2), and 43 (3.9%) had Padua scores of at least 4 points at admission. Regarding the severity of COVID-19, 543 (48.7%), 315 (28.2%), 204 (18.3%), and 54 (4.8%) patients had mild, moderate, severe, and critical COVID-19, respectively. Nine patients (0.8%) died, and 47 patients (4.2%) were transferred to other hospitals for intensive care. The primary outcome occurred in only 5 patients (0.5%; 95% CI, 0.1-0.8) and consisted of 3 ischemic strokes, 2 limb ischemia events, and one asymptomatic pulmonary embolism. Even in the 204 patients with severe COVID-19, the prevalence of thromboembolic complications was only 2.5% (95% CI, 0.3-4.6).
Thromboembolic complications of COVID-19 are rare even in severe cases in a medical ward in a Japanese hospital. Further studies are needed to identify severe COVID-19 patients with a higher risk for thromboembolic complications in Japan.
血栓栓塞并发症的高发是 COVID-19 的特征之一。然而，亚洲人和西方人之间血栓栓塞并发症的发生率可能存在差异。此外，很少有前瞻性研究来确定日本内科病房住院 COVID-19 患者的血栓栓塞并发症发生率。
进行了一项单中心回顾性和前瞻性队列研究，以确定日本一家医院内科病房有症状 COVID-19 患者的血栓栓塞并发症发生率。纳入了 2020 年 11 月 1 日至 2021 年 10 月 26 日期间连续收治的 1116 例 COVID-19 患者。主要结局是任何血栓栓塞并发症，包括静脉血栓栓塞、心肌梗死、缺血性卒中和其他动脉栓塞。
患者中位年龄为 50（IQR，37-61）岁，402 例（36.0%）为女性，1005 例（90.1%）为日本人，中位体质指数为 24.1（IQR，21.6-27.2），入院时 43 例（3.9%）的 Padua 评分至少为 4 分。根据 COVID-19 的严重程度，543 例（48.7%）、315 例（28.2%）、204 例（18.3%）和 54 例（4.8%）患者的 COVID-19 分别为轻症、中度、重症和危重症。9 例患者（0.8%）死亡，47 例患者（4.2%）转往其他医院进行重症监护。主要结局仅发生在 5 例患者（0.5%；95%CI，0.1-0.8）中，包括 3 例缺血性卒中和 2 例肢体缺血事件，以及 1 例无症状肺栓塞。即使在 204 例重症 COVID-19 患者中，血栓栓塞并发症的发生率也仅为 2.5%（95%CI，0.3-4.6）。
即使在日本内科病房的重症 COVID-19 患者中，血栓栓塞并发症也很少见。需要进一步研究以确定日本高危 COVID-19 患者中发生血栓栓塞并发症的严重程度。
