Tecnológico de Monterrey, School of Medicine and Health Sciences, Monterrey, Nuevo León, México.
Vasc Endovascular Surg. 2023 Aug;57(6):592-598. doi: 10.1177/15385744231163976. Epub 2023 Mar 15.
Assess heterogeneity within patients with resolved COVID-19 to broaden the vision about post-discharge thrombotic cases and postulate possible related mechanisms in search of better anticoagulation guidelines. This study details patients' characteristics, medical history, treatment, and outcomes of readmitted patients with late acute thrombosis through a systematic review of the literature and patients from our academic center database.
We extracted the records of patients readmitted for venous thrombosis complications after discharge from the database of the first 2000 patients admitted with COVID-19 in our academic center; we also performed a systematic review of the literature using the Medical Subject Headings terms "late thrombosis," "COVID-19," + "venous thrombosis" in PubMed and Google Scholar according to PRISMA guideline.
The literature review found 20 patients suitable for review matching the inclusion criteria. These patients were added to those in our database, summing up a total of 26 patients. The median age was 50 years old, 76.9% were male, and most were overweight or had grade 1 obesity (n = 11, 42.3%). None had a previous thrombotic history, but 50% had an underlying comorbidity. Thrombotic events presented on a median of 20 days (range: 4-150 days) from discharge. Pulmonary embolisms occurred in 23 patients (88.46%), deep vein thrombosis in 4, mesenteric thrombosis, and cerebral venous thrombosis in 1, respectively.
This study found that most patients readmitted for thrombotic events after COVID-19 discharge were middle-aged men with Venous Thrombo Embolism events.
评估已康复 COVID-19 患者的异质性,拓宽对出院后血栓病例的认识,并推测可能的相关机制,以寻求更好的抗凝指南。本研究通过对我院学术中心数据库中患者的回顾性分析以及对文献的系统回顾,详细描述了因晚期急性血栓而再次入院的患者的特征、病史、治疗和结局。
我们从我院学术中心收治的前 2000 例 COVID-19 患者数据库中提取了因静脉血栓并发症出院后再次入院的患者记录;我们还按照 PRISMA 指南使用“晚期血栓形成”、“COVID-19”和“静脉血栓形成”等医学主题词在 PubMed 和 Google Scholar 上进行了文献系统回顾。
文献综述共找到 20 例符合纳入标准的适合回顾的患者。这些患者与我们数据库中的患者相加,共 26 例患者。中位年龄为 50 岁,76.9%为男性,大多数超重或为 1 级肥胖(n=11,42.3%)。患者均无既往血栓病史,但 50%有潜在合并症。血栓事件发生在出院后中位 20 天(范围:4-150 天)。23 例(88.46%)患者发生肺栓塞,4 例发生深静脉血栓形成,1 例发生肠系膜血栓形成和 1 例发生脑静脉血栓形成。
本研究发现,大多数因 COVID-19 出院后发生血栓事件再次入院的患者为中年男性,静脉血栓栓塞事件更为常见。