Cardiovascular Medicine Division, Brigham and Women's Hospital, Harvard Medical School, USA; Thrombosis Research Group, Brigham and Women's Hospital, Harvard Medical School, USA; YNHH/ Yale Center for Outcomes Research and Evaluation (CORE), New Haven, CT, USA; Cardiovascular Research Foundation (CRF), New York, NY, USA.
Cardiovascular Medicine Division, Brigham and Women's Hospital, Harvard Medical School, USA; Thrombosis Research Group, Brigham and Women's Hospital, Harvard Medical School, USA.
Thromb Res. 2024 May;237:209-215. doi: 10.1016/j.thromres.2024.02.021. Epub 2024 Apr 6.
Pregnancy may contribute to an excess risk of thrombotic or cardiovascular events. COVID-19 increases the risk of these events, although the risk is relatively limited among outpatients. We sought to determine whether outpatient pregnant women with COVID-19 are at a high risk for cardiovascular or thrombotic events.
MATERIALS & METHODS: We analyzed pregnant outpatients with COVID-19 from the multicenter CORONA-VTE-Network registry. The main study outcomes were a composite of adjudicated venous or arterial thrombotic events, and a composite of adjudicated cardiovascular events. Events were assessed 90 days after the COVID-19 diagnosis and reported for non-pregnant women ≤45 years, and for men ≤45 years, as points of reference.
Among 6585 outpatients, 169 were pregnant at diagnosis. By 90-day follow-up, two pregnant women during the third trimester had lower extremity venous thrombosis, one deep and one superficial vein thrombosis. The cumulative incidence of thrombotic events was 1.20 % (95 % confidence interval [CI]: 0.0 to 2.84 %). Respective rates were 0.47 % (95 % CI: 0.14 % to 0.79 %) among non-pregnant women, and 0.49 % (95 % CI: 0.06 % to 0.91 %) among men ≤45 years. No non-thrombotic cardiovascular events occurred in pregnant women. The rates of cardiovascular events were 0.53 % (95 % CI: 0.18 to 0.87) among non-pregnant women, and 0.68 % (95 % CI: 0.18 to 1.18) in men aged ≤45 years.
Thrombotic and cardiovascular events are rare among outpatients with COVID-19. Although a higher event rate among outpatient pregnant women cannot be excluded, the absolute event rates are low and do not warrant population-wide cardiovascular interventions to optimize outcomes.
妊娠可能会增加血栓形成或心血管事件的风险。COVID-19 增加了这些事件的风险，尽管在门诊患者中风险相对有限。我们试图确定患有 COVID-19 的门诊孕妇是否存在发生心血管或血栓形成事件的高风险。
我们分析了来自多中心 CORONA-VTE-Network 登记处的患有 COVID-19 的门诊孕妇。主要研究结果是经裁决的静脉或动脉血栓形成事件的复合，以及经裁决的心血管事件的复合。在 COVID-19 诊断后 90 天评估事件，并为非孕妇（年龄≤45 岁）和男性（年龄≤45 岁）报告参考点。
在 6585 名门诊患者中，有 169 名在诊断时怀孕。在 90 天的随访期间，两名妊娠晚期的孕妇发生下肢静脉血栓形成，一条深静脉和一条浅静脉血栓形成。血栓形成事件的累积发生率为 1.20%（95%置信区间[CI]：0.0 至 2.84%）。相应的发生率分别为非孕妇中的 0.47%（95%CI：0.14%至 0.79%）和男性（年龄≤45 岁）中的 0.49%（95%CI：0.06%至 0.91%）。孕妇中没有发生非血栓性心血管事件。心血管事件的发生率分别为非孕妇中的 0.53%（95%CI：0.18%至 0.87%）和男性（年龄≤45 岁）中的 0.68%（95%CI：0.18%至 1.18%）。
COVID-19 门诊患者中血栓形成和心血管事件罕见。尽管不能排除门诊孕妇的事件发生率较高，但绝对事件发生率较低，不需要进行人群范围的心血管干预以优化结局。
