代偿期肝硬化患者感染新型冠状病毒2的血栓形成长期后果：美国数据库的倾向评分匹配分析

Thrombotic Long-Term Consequences of SARS-CoV-2 Infection in Patients with Compensated Cirrhosis: A Propensity Score-Matched Analysis of a U.S. Database.

作者信息

Ayoub Mark, Faris Carol, Juranovic Tajana, Aibani Rafi, Koontz Morgan, Chela Harleen, Anwar Nadeem, Daglilar Ebubekir

机构信息

Department of Internal Medicine, Charleston Area Medical Center, West Virginia University, Charleston, WV 25304, USA.

Department of Internal Medicine, Bayonne Medical Center, Bayonne, NJ 07002, USA.

出版信息

Diseases. 2024 Jul 17;12(7):161. doi: 10.3390/diseases12070161.

DOI:10.3390/diseases12070161

PMID:39057132

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11276382/

Abstract

BACKGROUND

Cirrhosis causes an imbalance in the coagulation pathway and leads to a tendency for both bleeding and clotting. SARS-CoV-2 has been reported to be associated with a hypercoagulable state. This study examines SARS-CoV-2's impact on hemostasis in compensated patients with cirrhosis.

METHODS

We analyzed the US Collaborative Network, which comprises 63 HCOs in the U.S.A. Compensated cirrhosis patients were split into two groups: SARS-CoV-2-positive and -negative. Patients' baseline characteristics were used in a 1:1 propensity score-matched module to create comparable cohorts. We compared the risk of portal vein thrombosis (PVT), deep venous thrombosis (DVT), and pulmonary embolism (PE) at 6 months, and 1 and 3 years.

RESULTS

Of 330,521 patients, 27% tested positive and 73% remained negative. After PSM, both cohorts included 74,738 patients. Patients with SARS-CoV-2 had a higher rate of PVT compared to those without at 6 months (0.63% vs 0.5%, < 0.05), 1 year (0.8% vs 0.6%, < 0.05), and 3 years (1% vs. 0.7%, < 0.05), a higher rate of DVT at 6 months (0.8% vs. 0.4%, < 0.05), 1 year (1% vs. 0.5%, < 0.05), and 3 years (1.4% vs. 0.8%, < 0.05), and a higher rate of PE at 6 months (0.6% vs. 0.3%, < 0.05), 1 year (0.7% vs. 0.4%, < 0.05), and 3 years (1% vs. 0.6%, < 0.05).

CONCLUSIONS

The presence of SARS-CoV-2 infection in patients with compensated cirrhosis was associated with a higher rate of PVT, DVT, and PE at 6 months, and 1 and 3 years.

摘要

背景

肝硬化会导致凝血途径失衡，进而引发出血和凝血倾向。据报道，严重急性呼吸综合征冠状病毒2（SARS-CoV-2）与高凝状态有关。本研究旨在探讨SARS-CoV-2对代偿期肝硬化患者止血功能的影响。

方法

我们分析了美国协作网络，该网络由美国63家医疗保健机构组成。代偿期肝硬化患者被分为两组：SARS-CoV-2阳性组和阴性组。患者的基线特征用于1:1倾向评分匹配模块，以创建可比队列。我们比较了6个月、1年和3年时门静脉血栓形成（PVT）、深静脉血栓形成（DVT）和肺栓塞（PE）的风险。

结果

在330,521名患者中，27%检测呈阳性，73%仍为阴性。倾向评分匹配后，两个队列各有74,738名患者。SARS-CoV-2感染患者在6个月时的PVT发生率高于未感染患者（0.63%对0.5%，P<0.05），1年时（0.8%对0.6%，P<0.05），3年时（1%对0.7%，P<0.05）；6个月时的DVT发生率更高（0.8%对0.4%，P<0.05），1年时（1%对0.5%，P<0.05），3年时（1.4%对0.8%，P<0.05）；6个月时的PE发生率更高（0.6%对0.3%，P<0.05），1年时（0.7%对0.4%，P<0.05），3年时（1%对0.6%，P<0.05）。