Jinn Alison, Kammermayer Michael, Mabasa Vincent H, Liu Tracy, Paul Tarnvir Sonia, Phan Nam
, BSc(Pharm), ACPR, was, at the time of this study, a Postgraduate Year 1 Resident with Lower Mainland Pharmacy Services, Fraser Health Authority, Burnaby, British Columbia. She is now a Clinical Pharmacist with the Pharmacy Department, Royal Columbian Hospital, New Westminster, British Columbia.
, BSc, PharmD, ACPR, was, at the time of this study, a Clinical Pharmacy Specialist - Internal Medicine with the Pharmacy Department, Burnaby Hospital, Burnaby, British Columbia, and is now the Clinical Pharmacy Supervisor with the same department and hospital.
Can J Hosp Pharm. 2024 Apr 10;77(2):e3505. doi: 10.4212/cjhp.3505. eCollection 2024.
Severe COVID-19 is associated with increased rates of thrombotic complications. Recent provincial recommendations in British Columbia have suggested providing thromboprophylaxis with therapeutic anticoagulation for hospital inpatients with severe COVID-19 who do not have a high risk of bleeding.
To characterize the rates of major bleeding, thrombotic events, complications from COVID-19, and adverse effects among patients with severe COVID-19 treated with therapeutic anticoagulation.
This retrospective chart review involved patients with laboratory-confirmed COVID-19 who were admitted to 3 sites within a local health authority between April 1 and December 31, 2021, and received therapeutic anticoagulation for thromboprophylaxis.
After screening of 1036 patients, 72 patients were included in the study. The mean age of participants was 54 years, 63% ( = 45) were male, and 92% ( = 66) were receiving supplemental oxygen by nasal prongs on admission. The primary outcome, major bleeding, was experienced by 1 patient (1%). Increasing oxygen requirements resulting in progression to high-flow nasal cannula occurred in 11 patients (15%), and 5 patients (7%) required admission to the intensive care unit. One patient (1%) experienced a thrombotic event, and 1 patient (1%) had a minor bleed. The mean duration of hospitalization was 10 (standard deviation 10.8) days. One death occurred during the study period, and no cases of heparin-induced thrombocytopenia were observed.
In this study of hospital inpatients with severe COVID-19 who were deemed to be at low risk of bleeding and who received therapeutic anticoagulation, there were low rates of both major bleeding and thrombotic events.
重症新型冠状病毒肺炎（COVID-19）与血栓形成并发症发生率增加相关。不列颠哥伦比亚省最近的省级建议提出，对于无高出血风险的重症COVID-19住院患者，应给予治疗性抗凝进行血栓预防。
描述接受治疗性抗凝的重症COVID-19患者的大出血、血栓形成事件、COVID-19并发症及不良反应发生率。
这项回顾性病历审查纳入了2021年4月1日至12月31日期间在当地卫生当局的3个地点住院、实验室确诊为COVID-19并接受治疗性抗凝进行血栓预防的患者。
在筛查的1036例患者中，72例纳入研究。参与者的平均年龄为54岁，63%（n = 45）为男性，92%（n = 66）入院时通过鼻导管吸氧。1例患者（1%）发生主要结局大出血。11例患者（15%）因吸氧需求增加而升级为高流量鼻导管吸氧，5例患者（7%）需要入住重症监护病房。1例患者（1%）发生血栓形成事件，1例患者（1%）发生轻微出血。平均住院时间为10（标准差10.8）天。研究期间发生1例死亡，未观察到肝素诱导的血小板减少症病例。
在这项针对被认为出血风险低且接受治疗性抗凝的重症COVID-19住院患者的研究中，大出血和血栓形成事件的发生率均较低。
