Venous Thromboembolism and Major Bleeding in Patients With Coronavirus Disease 2019 (COVID-19) : A Nationwide, Population-Based Cohort Study
© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissionsoup.com..
BACKGROUND: Venous thromboembolism (VTE) is a potentially fatal complication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and thromboprophylaxis should be balanced against risk of bleeding. This study examined risks of VTE and major bleeding in hospitalized and community-managed SARS-CoV-2 patients compared with control populations.
METHODS: Using nationwide population-based registries, 30-day risks of VTE and major bleeding in SARS-CoV-2 positive patients were compared with those of SARS-CoV-2 test-negative patients and with an external cohort of influenza patients. Medical records of all COVID-19 patients at 6 departments of infectious diseases in Denmark were reviewed in detail.
RESULTS: The overall 30-day risk of VTE was 0.4% (40/9460) among SARS-CoV-2 patients (16% hospitalized), 0.3% (649/226 510) among SARS-CoV-2 negative subjects (12% hospitalized), and 1.0% (158/16 281) among influenza patients (59% hospitalized). VTE risks were higher and comparable in hospitalized SARS-CoV-2 positive (1.5%), SARS-CoV-2 negative (1.8%), and influenza patients (1.5%). Diagnosis of major bleeding was registered in 0.5% (47/9460) of all SARS-CoV-2 positive individuals and in 2.3% of those hospitalized. Medical record review of 582 hospitalized SARS-CoV-2 patients observed VTE in 4% (19/450) and major bleeding in 0.4% (2/450) of ward patients, of whom 31% received thromboprophylaxis. Among intensive care patients (100% received thromboprophylaxis), risks were 7% (9/132) for VTE and 11% (15/132) for major bleeding.
CONCLUSIONS: Among people with SARS-CoV-2 infection in a population-based setting, VTE risks were low to moderate and were not substantially increased compared with SARS-CoV-2 test-negative and influenza patients. Risk of severe bleeding was low for ward patients, but mirrored VTE risk in the intensive care setting.
| Errataetall: |
CommentIn: Clin Infect Dis. 2021 Dec 16;73(12):2294-2297. - PMID 33539504 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:73 |
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| Enthalten in: |
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America - 73(2021), 12 vom: 16. Dez., Seite 2283-2293 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Dalager-Pedersen, Michael [VerfasserIn] |
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| Links: |
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| Themen: |
Anticoagulants |
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| Anmerkungen: |
Date Completed 22.12.2021 Date Revised 22.12.2021 published: Print CommentIn: Clin Infect Dis. 2021 Dec 16;73(12):2294-2297. - PMID 33539504 Citation Status MEDLINE |
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| doi: |
10.1093/cid/ciab003 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM319646041 |
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| 100 | 1 | |a Dalager-Pedersen, Michael |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Venous Thromboembolism and Major Bleeding in Patients With Coronavirus Disease 2019 (COVID-19) |b A Nationwide, Population-Based Cohort Study |
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| 500 | |a Date Completed 22.12.2021 | ||
| 500 | |a Date Revised 22.12.2021 | ||
| 500 | |a published: Print | ||
| 500 | |a CommentIn: Clin Infect Dis. 2021 Dec 16;73(12):2294-2297. - PMID 33539504 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissionsoup.com. | ||
| 520 | |a BACKGROUND: Venous thromboembolism (VTE) is a potentially fatal complication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and thromboprophylaxis should be balanced against risk of bleeding. This study examined risks of VTE and major bleeding in hospitalized and community-managed SARS-CoV-2 patients compared with control populations | ||
| 520 | |a METHODS: Using nationwide population-based registries, 30-day risks of VTE and major bleeding in SARS-CoV-2 positive patients were compared with those of SARS-CoV-2 test-negative patients and with an external cohort of influenza patients. Medical records of all COVID-19 patients at 6 departments of infectious diseases in Denmark were reviewed in detail | ||
| 520 | |a RESULTS: The overall 30-day risk of VTE was 0.4% (40/9460) among SARS-CoV-2 patients (16% hospitalized), 0.3% (649/226 510) among SARS-CoV-2 negative subjects (12% hospitalized), and 1.0% (158/16 281) among influenza patients (59% hospitalized). VTE risks were higher and comparable in hospitalized SARS-CoV-2 positive (1.5%), SARS-CoV-2 negative (1.8%), and influenza patients (1.5%). Diagnosis of major bleeding was registered in 0.5% (47/9460) of all SARS-CoV-2 positive individuals and in 2.3% of those hospitalized. Medical record review of 582 hospitalized SARS-CoV-2 patients observed VTE in 4% (19/450) and major bleeding in 0.4% (2/450) of ward patients, of whom 31% received thromboprophylaxis. Among intensive care patients (100% received thromboprophylaxis), risks were 7% (9/132) for VTE and 11% (15/132) for major bleeding | ||
| 520 | |a CONCLUSIONS: Among people with SARS-CoV-2 infection in a population-based setting, VTE risks were low to moderate and were not substantially increased compared with SARS-CoV-2 test-negative and influenza patients. Risk of severe bleeding was low for ward patients, but mirrored VTE risk in the intensive care setting | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a bleeding | |
| 650 | 4 | |a deep venous thrombosis | |
| 650 | 4 | |a hemorrhage | |
| 650 | 4 | |a pulmonary embolism | |
| 650 | 4 | |a venous thromboembolism | |
| 650 | 7 | |a Anticoagulants |2 NLM | |
| 700 | 1 | |a Lund, Lars Christian |e verfasserin |4 aut | |
| 700 | 1 | |a Mariager, Theis |e verfasserin |4 aut | |
| 700 | 1 | |a Winther, Rannva |e verfasserin |4 aut | |
| 700 | 1 | |a Hellfritzsch, Maja |e verfasserin |4 aut | |
| 700 | 1 | |a Larsen, Torben Bjerregaard |e verfasserin |4 aut | |
| 700 | 1 | |a Thomsen, Reimar Wernich |e verfasserin |4 aut | |
| 700 | 1 | |a Johansen, Nanna Borup |e verfasserin |4 aut | |
| 700 | 1 | |a Søgaard, Ole Schmeltz |e verfasserin |4 aut | |
| 700 | 1 | |a Nielsen, Stig Lønberg |e verfasserin |4 aut | |
| 700 | 1 | |a Omland, Lars Haukali |e verfasserin |4 aut | |
| 700 | 1 | |a Lundbo, Lene Fogt |e verfasserin |4 aut | |
| 700 | 1 | |a Israelsen, Simone Bastrup |e verfasserin |4 aut | |
| 700 | 1 | |a Harboe, Zitta Barrella |e verfasserin |4 aut | |
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| 700 | 1 | |a Nielsen, Henrik |e verfasserin |4 aut | |
| 700 | 1 | |a Bodilsen, Jacob |e verfasserin |4 aut | |
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