Faculty of Medicine and Pharmacy, 212165Mohammed Ist University, Oujda, Morocco.
Department of Intensive Care Unit, Mohammed VI University Hospital Mohammed I University, Oujda, Morocco.
Clin Appl Thromb Hemost. 2023 Jan-Dec;29:10760296231151710. doi: 10.1177/10760296231151710.
Our objective in this study is to know the predictors of thromboembolic events 1 year after hospitalization for severe COVID-19 and the benefit of preventive oral anticoagulation for 1 month to placebo after release. We conducted a prospective study to determine the benefit of preventive anticoagulation upon discharge from the hospital and to determine the predictive factors of thromboembolic events. We included 720 patients in the SARCOV-19 Registry, with a mean age of 62.07 (±18.11), and 61.1% male. After 1 year, 60 thromboembolic events were observed, 45 in patients on a placebo, and 15 in patients on a direct oral anticoagulant. The predictive factors determined for these events were the presence of cardiac disease, elevation of D-dimer during hospitalization, myocardial damage defined by elevation of troponins more than 6 times normal, and the use of mechanical ventilation. However, the use of preventive anticoagulation protects against thrombotic events and reduces the risk of a thromboembolic event at 1 year with a relative risk of 0.49 compared to a placebo. The prolongation of the preventive anticoagulation at the exit will protect with a decrease of almost 50% of the risk against thrombotic events and this without increasing the risk of bleeding.
本研究旨在探讨严重 COVID-19 住院 1 年后发生血栓栓塞事件的预测因素，以及出院后使用预防性口服抗凝药（OAC）与安慰剂相比的获益。我们进行了一项前瞻性研究，以确定出院时预防性抗凝的获益，并确定血栓栓塞事件的预测因素。我们纳入了 SARCOV-19 登记处的 720 例患者，平均年龄为 62.07（±18.11）岁，61.1%为男性。1 年后，观察到 60 例血栓栓塞事件，其中 45 例发生在安慰剂组，15 例发生在直接口服抗凝剂组。这些事件的预测因素为存在心脏病、住院期间 D-二聚体升高、肌钙蛋白升高超过正常值 6 倍定义的心肌损伤以及使用机械通气。然而，预防性抗凝的使用可预防血栓事件，并将 1 年时的血栓栓塞事件风险降低 50%，与安慰剂相比，相对风险为 0.49。延长出院时的预防性抗凝治疗可将血栓事件的风险降低近 50%，且不会增加出血风险。
