Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, 20122 Milan, Italy.
III Infectious Diseases Unit, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, 20157 Milan, Italy.
Medicina (Kaunas). 2024 May 15;60(5):814. doi: 10.3390/medicina60050814.
Thromboprophylaxis/anticoagulation treatment is often required in hospitalized COVID-19 patients. We aimed to estimate the prevalence of major bleeding events in hospitalized COVID-19 patients. This was a retrospective observational study including all COVID-19 hospitalized patients ≥18 years of age at one reference center in northern Italy. The crude prevalence (between February 2020-2022) of major bleeding events was estimated as the number of major bleeding episodes divided by patients at risk. Uni- and multivariable Cox models were built to assess factors potentially associated with major bleeding events. Twenty-nine (0.98%) out of 2,945 COVID-19 patients experienced a major bleeding event [prevalence of 0.55% (95%CI 0.37-0.79)], of which five were fatal. Patients who experienced a major bleeding event were older [78 years (72-84 IQR) vs. 67 years (55-78 IQR), -value < 0.001] and more frequently exposed to anti-aggregating therapy (44.8% vs. 20.0%, -value 0.002) when compared to those who did not. In the multivariable Cox model, age [per 1 year more AHR 1.05 (CI95% 1.02-1.09)] was independently associated with an increased risk of major bleeding events. A strict monitoring of older hospitalized COVID-19 patients is warranted due to the risk of major bleeding events.
在住院的 COVID-19 患者中，通常需要进行血栓预防/抗凝治疗。我们旨在估计住院 COVID-19 患者中主要出血事件的发生率。这是一项回顾性观察性研究，包括意大利北部一个参考中心的所有≥18 岁的 COVID-19 住院患者。主要出血事件的粗发生率（2020 年 2 月至 2022 年期间）估计为主要出血事件的数量除以处于风险中的患者数。建立了单变量和多变量 Cox 模型，以评估与主要出血事件相关的潜在因素。在 2945 例 COVID-19 患者中，有 29 例（0.98%）发生了主要出血事件[发生率为 0.55%（95%CI 0.37-0.79%）]，其中 5 例死亡。与未发生主要出血事件的患者相比，发生主要出血事件的患者年龄更大[78 岁（72-84 IQR）与 67 岁（55-78 IQR），-值<0.001]，且更频繁地接受抗聚集治疗（44.8%与 20.0%，-值 0.002）。在多变量 Cox 模型中，年龄[每增加 1 岁，AHR 增加 1.05（95%CI 1.02-1.09）]与主要出血事件的风险增加独立相关。由于主要出血事件的风险，应严格监测住院的老年 COVID-19 患者。
