Arterial and venous thrombosis in coronavirus 2019 disease (Covid-19): relationship with mortality
Background Patients with coronavirus disease 2019 (Covid-19) may experience venous thrombosis while data regarding arterial thrombosis are sparse. Methods Prospective multicenter study in 5 hospitals including 373 patients with Covid-19-related pneumonia. Demographic data, laboratory findings including coagulation tests and comorbidities were reported. During the follow-up any arterial or venous thrombotic events and death were registered. Results Among 373 patients, 75 (20%) had a thrombotic event and 75 (20%) died. Thrombotic events included 41 venous thromboembolism and 34 arterial thrombosis. Age, cardiovascular disease, intensive care unit treatment, white blood cells, D-dimer, albumin and troponin blood levels were associated with thrombotic events. In a multivariable regression logistic model, intensive care unit treatment (Odds Ratio [OR]: 6.0; 95% Confidence Interval [CI] 2.8–12.6; p < 0.001); coronary artery disease (OR: 2.4; 95% CI 1.4–5.0; p = 0.022); and albumin levels (OR: 0.49; 95% CI 0.28–0.87; p = 0.014) were associated with ischemic events. Age, sex, chronic obstructive pulmonary disease, diabetes, heart failure, coronary heart disease, intensive care unit treatment, in-hospital thrombotic events, D-dimer, C-reactive protein, troponin, and albumin levels were associated with mortality. A multivariable Cox regression analysis showed that in-hospital thrombotic events (hazard ratio [HR]: 2.72; 95% CI 1.59–4.65; p < 0.001), age (HR: 1.035; 95% CI 1.014–1.057; p = 0.001), and albumin (HR: 0.447; 95% CI 0.277–0.723; p = 0.001) predicted morality. Conclusions Covid-19 patients experience an equipollent rate of venous and arterial thrombotic events, that are associated with poor survival. Early identification and appropriate treatment of Covid-19 patients at risk of thrombosis may improve prognosis..
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Artikel |
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Erscheinungsjahr: |
2021 |
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Erschienen: |
2021 |
Enthalten in: |
Zur Gesamtaufnahme - volume:16 |
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Enthalten in: |
Internal and emergency medicine - 16(2021), 5 vom: 04. Juli, Seite 1231-1237 |
Sprache: |
Englisch |
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Beteiligte Personen: |
Violi, Francesco [VerfasserIn] |
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Volltext [lizenzpflichtig] |
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© The Author(s) 2021 |
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doi: |
10.1007/s11739-020-02621-8 |
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OLC2126851192 |
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520 | |a Background Patients with coronavirus disease 2019 (Covid-19) may experience venous thrombosis while data regarding arterial thrombosis are sparse. Methods Prospective multicenter study in 5 hospitals including 373 patients with Covid-19-related pneumonia. Demographic data, laboratory findings including coagulation tests and comorbidities were reported. During the follow-up any arterial or venous thrombotic events and death were registered. Results Among 373 patients, 75 (20%) had a thrombotic event and 75 (20%) died. Thrombotic events included 41 venous thromboembolism and 34 arterial thrombosis. Age, cardiovascular disease, intensive care unit treatment, white blood cells, D-dimer, albumin and troponin blood levels were associated with thrombotic events. In a multivariable regression logistic model, intensive care unit treatment (Odds Ratio [OR]: 6.0; 95% Confidence Interval [CI] 2.8–12.6; p < 0.001); coronary artery disease (OR: 2.4; 95% CI 1.4–5.0; p = 0.022); and albumin levels (OR: 0.49; 95% CI 0.28–0.87; p = 0.014) were associated with ischemic events. Age, sex, chronic obstructive pulmonary disease, diabetes, heart failure, coronary heart disease, intensive care unit treatment, in-hospital thrombotic events, D-dimer, C-reactive protein, troponin, and albumin levels were associated with mortality. A multivariable Cox regression analysis showed that in-hospital thrombotic events (hazard ratio [HR]: 2.72; 95% CI 1.59–4.65; p < 0.001), age (HR: 1.035; 95% CI 1.014–1.057; p = 0.001), and albumin (HR: 0.447; 95% CI 0.277–0.723; p = 0.001) predicted morality. Conclusions Covid-19 patients experience an equipollent rate of venous and arterial thrombotic events, that are associated with poor survival. Early identification and appropriate treatment of Covid-19 patients at risk of thrombosis may improve prognosis. | ||
650 | 4 | |a Covid-19 | |
650 | 4 | |a SARS-cov-2 | |
650 | 4 | |a Thrombosis | |
650 | 4 | |a Mortality | |
700 | 1 | |a Ceccarelli, Giancarlo |4 aut | |
700 | 1 | |a Cangemi, Roberto |4 aut | |
700 | 1 | |a Cipollone, Francesco |4 aut | |
700 | 1 | |a D’Ardes, Damiano |4 aut | |
700 | 1 | |a Oliva, Alessandra |4 aut | |
700 | 1 | |a Pirro, Matteo |4 aut | |
700 | 1 | |a Rocco, Monica |4 aut | |
700 | 1 | |a Alessandri, Francesco |4 aut | |
700 | 1 | |a D’Ettorre, Gabriella |4 aut | |
700 | 1 | |a Lichtner, Miriam |4 aut | |
700 | 1 | |a Pignatelli, Pasquale |4 aut | |
700 | 1 | |a Ferro, Domenico |4 aut | |
700 | 1 | |a Ruberto, Franco |4 aut | |
700 | 1 | |a Lip, Gregory Y. H. |4 aut | |
700 | 1 | |a Pugliese, Francesco |4 aut | |
700 | 1 | |a Mastroianni, Claudio Maria |4 aut | |
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