Hematology department, University hospital Dubrava, Zagreb, Croatia; School of Medicine University of Zagreb, Zagreb, Croatia.
Cardiology department, University hospital Dubrava, Zagreb, Croatia.
Am J Emerg Med. 2023 Aug;70:41-45. doi: 10.1016/j.ajem.2023.05.007. Epub 2023 May 10.
Venous thromboembolism (VTE) and arterial thrombotic (AT) events are a striking feature of severe COVID-19, however, relationship of remdesivir use and the risk of thrombotic events is unknown and has not been investigated before.
We retrospectively analyzed a cohort of 876 consecutive hospitalized severe and critical COVID-19 patients who were treated with remdesivir and compared them to 876 case-matched control patients. All patients were treated in our tertiary-level institution in period from 10/2020 to 6/2021. VTE and AT were diagnosed by objective imaging and laboratory methods.
After exclusion of 71 VTE and 37 AT events present at the time of hospital admission, there were a total of 70 VTE (35 in the remdesivir and 35 in the control group) and 38 AT events occurring during hospitalization (13 in the remdesivir and 25 in the control group). There was a similar cumulative post-admission VTE incidence among both remdesivir and matched control patients (P = 0.287). Significantly lower cumulative post-admission AT incidence was observed among patients treated with remdesivir than among matched control patients (1.7% vs 3.3%, HR = 0.51, P = 0.035). Tendency for lower AT rates was evident in subgroups of patients stratified according to the type of AT, as well as according to the intensity of required oxygen supplementation at the time of remdesivir use.
Remdesivir use in severe and critical COVID-19 patients might be associated with lower occurrence of AT during hospitalization, whereas similar rates of VTE events were observed among both patients treated with remdesivir and control patients.
静脉血栓栓塞症（VTE）和动脉血栓形成（AT）事件是严重 COVID-19 的突出特征，然而，瑞德西韦的使用与血栓形成事件的风险之间的关系尚不清楚，以前也没有进行过调查。
我们回顾性分析了 876 例连续住院的严重和危重新冠肺炎患者的队列，这些患者接受了瑞德西韦治疗，并将他们与 876 例匹配的对照患者进行了比较。所有患者均于 2020 年 10 月至 2021 年 6 月在我们的三级医疗机构接受治疗。VTE 和 AT 通过客观的影像学和实验室方法进行诊断。
排除入院时存在的 71 例 VTE 和 37 例 AT 事件后，共有 70 例 VTE（瑞德西韦组 35 例，对照组 35 例）和 38 例 AT 事件在住院期间发生（瑞德西韦组 13 例，对照组 25 例）。瑞德西韦组和匹配对照组患者的住院后累积 VTE 发生率相似（P=0.287）。与匹配对照组患者相比，接受瑞德西韦治疗的患者的住院后累积 AT 发生率显著降低（1.7% vs 3.3%，HR=0.51，P=0.035）。在根据 AT 类型以及在使用瑞德西韦时所需的氧气补充强度进行分层的患者亚组中，也观察到 AT 发生率较低的趋势。
在严重和危重新冠肺炎患者中使用瑞德西韦可能与住院期间 AT 的发生率降低有关，而接受瑞德西韦治疗的患者与对照组患者的 VTE 事件发生率相似。
