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评估门诊COVID-19病例中血栓栓塞并发症的负担:一项针对基层医疗中随访患者的重点研究。

Assessing the Burden of Thromboembolic Complications in Outpatient COVID-19 Cases: A Focused Study on Patients Followed in Primary Care.

作者信息

Usanma Koban Buğu, Çelik Özla, Sur Ünal Ülkü, Uzuner Arzu

机构信息

Family Medicine Department, Marmara University School of Medicine, İstanbul, Turkey.

Family Medicine, Fenerbahçe Family Healthcare Center, İstanbul, Turkey.

出版信息

Can J Infect Dis Med Microbiol. 2025 Jul 24;2025:7242450. doi: 10.1155/cjid/7242450. eCollection 2025.

Abstract

Thromboembolic complications are frequently observed in patients with COVID-19 infection, particularly among those admitted to the intensive care unit (ICU). Moreover, COVID-19 infections today are mostly characterized by mild symptoms and are managed primarily in primary care settings, resulting in limited literature data on thromboembolic complications in this patient group. This study aims to investigate thrombotic event risks and associated factors in the outpatient population. All outpatient COVID-19 cases managed at two family health centers in Istanbul between June 2020 and December 2021 were retrospectively reviewed. Patients were contacted and informed about the study. Sociodemographic and clinical data were obtained from family health center records, and information on thrombotic events was extracted from hospital discharge summaries. Fisher's exact test and logistic regression were used for analysis. A total of 961 patients were included in the study, of whom, 519 (54%) were female and 442 (46%) were male. The mean age was 41 years (range: 18-97). Thromboembolic events occurred in 4 patients (0.42%) within the first 6 months following COVID-19 infection. Logistic regression analysis identified the use of antacid medications (=0.01) and the presence of hematological disorders (=0.03) as significant risk factors. Thromboembolic events may occur even in mild-to-moderate outpatient COVID-19 cases within six months following the infection. Risk assessments focusing on comorbidities and medication use should be performed during outpatient follow-up. Due to the small number of thromboembolic events in this study, the findings should be considered preliminary and interpreted with caution. ClinicalTrials.gov identifier: NCT06695377.

摘要

血栓栓塞并发症在新冠病毒感染患者中经常出现,尤其是在入住重症监护病房(ICU)的患者中。此外,如今的新冠病毒感染大多症状较轻,主要在初级保健机构进行治疗,导致关于该患者群体血栓栓塞并发症的文献数据有限。本研究旨在调查门诊患者群体中血栓形成事件的风险及相关因素。对2020年6月至2021年12月期间在伊斯坦布尔两家家庭健康中心管理的所有门诊新冠病毒病例进行了回顾性分析。与患者取得联系并告知其研究情况。社会人口统计学和临床数据从家庭健康中心记录中获取,血栓形成事件信息从医院出院小结中提取。采用Fisher精确检验和逻辑回归进行分析。共有961名患者纳入研究,其中519名(54%)为女性,442名(46%)为男性。平均年龄为41岁(范围:18 - 97岁)。4例患者(0.42%)在新冠病毒感染后的前6个月内发生了血栓栓塞事件。逻辑回归分析确定使用抗酸药物(=0.01)和存在血液系统疾病(=0.03)为显著风险因素。即使在新冠病毒感染后6个月内症状为轻至中度的门诊患者中也可能发生血栓栓塞事件。在门诊随访期间应针对合并症和药物使用进行风险评估。由于本研究中血栓栓塞事件数量较少,研究结果应视为初步结果并谨慎解读。ClinicalTrials.gov标识符:NCT06695377。

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