Venous thromboembolism secondary to hospitalization for COVID-19 : patient management and long-term outcomes
© 2023 The Author(s)..
Background: Venous thromboembolism (VTE) is a complication of COVID-19 in hospitalized patients. Little information is available on long-term outcomes of VTE in this population.
Objectives: We aimed to compare the characteristics, management strategies, and long-term clinical outcomes between patients with COVID-19-associated VTE and patients with VTE provoked by hospitalization for other acute medical illnesses.
Methods: This is an observational cohort study, with a prospective cohort of 278 patients with COVID-19-associated VTE enrolled between 2020 and 2021 and a comparison cohort of 300 patients without COVID-19 enrolled in the ongoing START2-Register between 2018 and 2020. Exclusion criteria included age <18 years, other indications to anticoagulant treatment, active cancer, recent (<3 months) major surgery, trauma, pregnancy, and participation in interventional studies. All patients were followed up for a minimum of 12 months after treatment discontinuation. Primary end point was the occurrence of venous and arterial thrombotic events.
Results: Patients with VTE secondary to COVID-19 had more frequent pulmonary embolism without deep vein thrombosis than controls (83.1% vs 46.2%, P <.001), lower prevalence of chronic inflammatory disease (1.4% and 16.3%, P <.001), and history of VTE (5.0% and 19.0%, P <.001). The median duration of anticoagulant treatment (194 and 225 days, P = 0.9) and the proportion of patients who discontinued anticoagulation (78.0% and 75.0%, P = 0.4) were similar between the 2 groups. Thrombotic event rates after discontinuation were 1.5 and 2.6 per 100 patient-years, respectively (P = 0.4).
Conclusion: The risk of recurrent thrombotic events in patients with COVID-19-associated VTE is low and similar to the risk observed in patients with VTE secondary to hospitalization for other medical diseases.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:7 |
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| Enthalten in: |
Research and practice in thrombosis and haemostasis - 7(2023), 4 vom: 19. Mai, Seite 100167 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Ageno, Walter [VerfasserIn] |
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| Links: |
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| Themen: |
Anticoagulant treatment |
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| Anmerkungen: |
Date Revised 28.05.2023 published: Print-Electronic Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1016/j.rpth.2023.100167 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM357316657 |
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| 245 | 1 | 0 | |a Venous thromboembolism secondary to hospitalization for COVID-19 |b patient management and long-term outcomes |
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| 500 | |a Date Revised 28.05.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a © 2023 The Author(s). | ||
| 520 | |a Background: Venous thromboembolism (VTE) is a complication of COVID-19 in hospitalized patients. Little information is available on long-term outcomes of VTE in this population | ||
| 520 | |a Objectives: We aimed to compare the characteristics, management strategies, and long-term clinical outcomes between patients with COVID-19-associated VTE and patients with VTE provoked by hospitalization for other acute medical illnesses | ||
| 520 | |a Methods: This is an observational cohort study, with a prospective cohort of 278 patients with COVID-19-associated VTE enrolled between 2020 and 2021 and a comparison cohort of 300 patients without COVID-19 enrolled in the ongoing START2-Register between 2018 and 2020. Exclusion criteria included age <18 years, other indications to anticoagulant treatment, active cancer, recent (<3 months) major surgery, trauma, pregnancy, and participation in interventional studies. All patients were followed up for a minimum of 12 months after treatment discontinuation. Primary end point was the occurrence of venous and arterial thrombotic events | ||
| 520 | |a Results: Patients with VTE secondary to COVID-19 had more frequent pulmonary embolism without deep vein thrombosis than controls (83.1% vs 46.2%, P <.001), lower prevalence of chronic inflammatory disease (1.4% and 16.3%, P <.001), and history of VTE (5.0% and 19.0%, P <.001). The median duration of anticoagulant treatment (194 and 225 days, P = 0.9) and the proportion of patients who discontinued anticoagulation (78.0% and 75.0%, P = 0.4) were similar between the 2 groups. Thrombotic event rates after discontinuation were 1.5 and 2.6 per 100 patient-years, respectively (P = 0.4) | ||
| 520 | |a Conclusion: The risk of recurrent thrombotic events in patients with COVID-19-associated VTE is low and similar to the risk observed in patients with VTE secondary to hospitalization for other medical diseases | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a anticoagulant treatment | |
| 650 | 4 | |a pulmonary embolism | |
| 650 | 4 | |a recurrence | |
| 650 | 4 | |a venous thromboembolism | |
| 700 | 1 | |a Antonucci, Emilia |e verfasserin |4 aut | |
| 700 | 1 | |a Poli, Daniela |e verfasserin |4 aut | |
| 700 | 1 | |a Bucherini, Eugenio |e verfasserin |4 aut | |
| 700 | 1 | |a Chistolini, Antonio |e verfasserin |4 aut | |
| 700 | 1 | |a Fregoni, Vittorio |e verfasserin |4 aut | |
| 700 | 1 | |a Lerede, Teresa |e verfasserin |4 aut | |
| 700 | 1 | |a Pancani, Roberta |e verfasserin |4 aut | |
| 700 | 1 | |a Pedrini, Simona |e verfasserin |4 aut | |
| 700 | 1 | |a Pieralli, Filippo |e verfasserin |4 aut | |
| 700 | 1 | |a Pignatelli, Pasquale |e verfasserin |4 aut | |
| 700 | 1 | |a Pizzini, Attilia Maria |e verfasserin |4 aut | |
| 700 | 1 | |a Podda, Gian Marco |e verfasserin |4 aut | |
| 700 | 1 | |a Potere, Nicola |e verfasserin |4 aut | |
| 700 | 1 | |a Sarti, Luca |e verfasserin |4 aut | |
| 700 | 1 | |a Testa, Sophie |e verfasserin |4 aut | |
| 700 | 1 | |a Visonà, Adriana |e verfasserin |4 aut | |
| 700 | 1 | |a Palareti, Gualtiero |e verfasserin |4 aut | |
| 700 | 0 | |a START 2 Registry VTE study group |e verfasserin |4 aut | |
| 700 | 1 | |a Ageno, Walter |e investigator |4 oth | |
| 700 | 1 | |a Girardi, Laura |e investigator |4 oth | |
| 700 | 1 | |a Sterpone, Paola |e investigator |4 oth | |
| 700 | 1 | |a Cosmi, Benilde |e investigator |4 oth | |
| 700 | 1 | |a Bucherini, Eugenio |e investigator |4 oth | |
| 700 | 1 | |a Chistolini, Antonio |e investigator |4 oth | |
| 700 | 1 | |a Serrao, Alessandra |e investigator |4 oth | |
| 700 | 1 | |a Di Nisio, Marcello |e investigator |4 oth | |
| 700 | 1 | |a Potere, Nicola |e investigator |4 oth | |
| 700 | 1 | |a Porreca, Ettore |e investigator |4 oth | |
| 700 | 1 | |a Fregoni, Vittorio |e investigator |4 oth | |
| 700 | 1 | |a Grandone, Elvira |e investigator |4 oth | |
| 700 | 1 | |a Colaizzo, Donatella |e investigator |4 oth | |
| 700 | 1 | |a Insana, Antonio |e investigator |4 oth | |
| 700 | 1 | |a Lerede, Teresa |e investigator |4 oth | |
| 700 | 1 | |a Falanga, Anna |e investigator |4 oth | |
| 700 | 1 | |a Martinelli, Ida |e investigator |4 oth | |
| 700 | 1 | |a Bucciarelli, Paolo |e investigator |4 oth | |
| 700 | 1 | |a Abbattista, Maria |e investigator |4 oth | |
| 700 | 1 | |a Martini, Giuliana |e investigator |4 oth | |
| 700 | 1 | |a Masciocco, Lucilla |e investigator |4 oth | |
| 700 | 1 | |a Mastroiacovo, Daniela |e investigator |4 oth | |
| 700 | 1 | |a Pancani, Roberta |e investigator |4 oth | |
| 700 | 1 | |a Carrozzi, Laura |e investigator |4 oth | |
| 700 | 1 | |a Paparo, Carmelo |e investigator |4 oth | |
| 700 | 1 | |a Pedrini, Simona |e investigator |4 oth | |
| 700 | 1 | |a Pieralli, Filippo |e investigator |4 oth | |
| 700 | 1 | |a Milia, Alessandro |e investigator |4 oth | |
| 700 | 1 | |a Pignatelli, Pasquale |e investigator |4 oth | |
| 700 | 1 | |a Menichelli, Danilo |e investigator |4 oth | |
| 700 | 1 | |a Pizzini, Attilia Maria |e investigator |4 oth | |
| 700 | 1 | |a Silingardi, Mauro |e investigator |4 oth | |
| 700 | 1 | |a Podda, GianMarco |e investigator |4 oth | |
| 700 | 1 | |a Birocchi, Simone |e investigator |4 oth | |
| 700 | 1 | |a Poli, Daniela |e investigator |4 oth | |
| 700 | 1 | |a Crudele, Felice |e investigator |4 oth | |
| 700 | 1 | |a Lotti, Elena |e investigator |4 oth | |
| 700 | 1 | |a Marcucci, Rossella |e investigator |4 oth | |
| 700 | 1 | |a Preti, Paola Stefania |e investigator |4 oth | |
| 700 | 1 | |a Sarti, Luca |e investigator |4 oth | |
| 700 | 1 | |a Trovati, Alice |e investigator |4 oth | |
| 700 | 1 | |a Caronna, Antonella |e investigator |4 oth | |
| 700 | 1 | |a Famiglietti, Elena |e investigator |4 oth | |
| 700 | 1 | |a Lami, Francesca |e investigator |4 oth | |
| 700 | 1 | |a Nicolini, Alberto |e investigator |4 oth | |
| 700 | 1 | |a Scaglioni, Federica |e investigator |4 oth | |
| 700 | 1 | |a Testa, Sophie |e investigator |4 oth | |
| 700 | 1 | |a Paoletti, Oriana |e investigator |4 oth | |
| 700 | 1 | |a Tosetto, Alberto |e investigator |4 oth | |
| 700 | 1 | |a Toma, Andrea |e investigator |4 oth | |
| 700 | 1 | |a Villalta, Sabina |e investigator |4 oth | |
| 700 | 1 | |a Visonà, Adriana |e investigator |4 oth | |
| 700 | 1 | |a Zalunardo, Beniamino |e investigator |4 oth | |
| 700 | 1 | |a Panzavolta, Chiara |e investigator |4 oth | |
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