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住院 COVID-19 阳性患者的死亡和静脉血栓栓塞分析:一项多中心研究。

Death and Venous Thromboembolism Analyses among Hospitalized COVID-19-Positive Patients: A Multicenter Study.

作者信息

Alshahrani Asma, Almoahzieie Abdullah, Alshareef Hanan, Alammash Buthinah B, Alhamidi Sarah, Meraya Abdulkarim M, Alshammari Abdullah S, Ajlan Aziza, Alghofaili Alnajla, Alnassar Abdullah, Alshahrani Nada, Aldossari Maram, Alkhaldi Turkiah, Alwazzeh Marwan J, Almashouf Abdullah B, Alkuwaiti Feras A, Alghamdi Shrouq Hamed, Alshehri Ohuod, Ali Mostafa

机构信息

Department of Clinical Pharmacy, Faculty of Pharmacy, King Khalid University, Abha 62529, Saudi Arabia.

Pharmaceutical Care Division, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia.

出版信息

J Clin Med. 2023 Dec 11;12(24):7624. doi: 10.3390/jcm12247624.

Abstract

BACKGROUND

Coagulation disorders are frequently encountered among patients infected with coronavirus disease 2019 (COVID-19), especially among admitted patients with more severe symptoms. This study aims to determine the mortality rate and incidence and risk factors for venous thromboembolism (VTE) in hospitalized patients with COVID-19.

METHODS

This retrospective observational cohort study was conducted from March to July 2020 using a hospital database. All adult patients (>18 years old) with laboratory-confirmed COVID-19 were included. Laboratory data and the real-time reverse transcriptase-polymerase chain reaction (rRT-PCR) for SARS-CoV-2 were obtained from medical records. The mortality rate and the incidence of VTE were established as study results. A multivariate logistic regression analysis was performed to identify predictors of thrombotic events.

RESULTS

rA total of 1024 confirmed COVID-19 patients were treated, of whom 110 (10.7%) were deceased and 58 patients (5.7%) developed VTE. Death occurred more frequently in patients older than 50 years and those admitted to the intensive care unit (ICU, 95%) and who received mechanical ventilation (62.7%). Multivariate analysis revealed that cancer patients were two times more likely to have VTE (adjusted odds ratio = 2.614; 95% CI = (1.048-6.519); = 0.039). Other chronic diseases, such as diabetes, hypertension, and chronic kidney disease, were not associated with an increased risk of VTE.

CONCLUSIONS

One-tenth of hospitalized COVID-19 patients were deceased, and VTE was prevalent among patients with chronic conditions, such as cancer, despite anticoagulation therapy. Healthcare professionals should closely monitor individuals with a high risk of developing VTE to prevent unwanted complications.

摘要

背景

2019年冠状病毒病(COVID-19)感染患者中经常出现凝血功能障碍,尤其是症状较严重的住院患者。本研究旨在确定COVID-19住院患者的死亡率、静脉血栓栓塞症(VTE)的发生率及危险因素。

方法

本回顾性观察性队列研究于2020年3月至7月使用医院数据库进行。纳入所有实验室确诊为COVID-19的成年患者(>18岁)。从病历中获取实验室数据和针对严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的实时逆转录聚合酶链反应(rRT-PCR)结果。将死亡率和VTE发生率作为研究结果。进行多因素逻辑回归分析以确定血栓形成事件的预测因素。

结果

共治疗了1024例确诊的COVID-19患者,其中110例(10.7%)死亡,58例(5.7%)发生VTE。50岁以上患者、入住重症监护病房(ICU,95%)以及接受机械通气的患者(62.7%)死亡更为频繁。多因素分析显示,癌症患者发生VTE的可能性高出两倍(调整后的优势比 = 2.614;95%置信区间 = (1.048 - 6.519);P = 0.039)。其他慢性病,如糖尿病、高血压和慢性肾脏病,与VTE风险增加无关。

结论

十分之一的COVID-19住院患者死亡,尽管进行了抗凝治疗,但VTE在患有癌症等慢性病的患者中很普遍。医护人员应密切监测发生VTE高风险的个体,以预防不良并发症。

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