J Cardiol . The current status of thrombosis and anticoagulation therapy in patients with COVID-19 in Japan: From the CLOT-COVID study

[tetano]

J Cardiol


. 2022 Apr 5;S0914-5087(22)00075-2.
doi: 10.1016/j.jjcc.2022.03.015. Online ahead of print.
The current status of thrombosis and anticoagulation therapy in patients with COVID-19 in Japan: From the CLOT-COVID study


Yuji Nishimoto ¹ , Sen Yachi ² , Makoto Takeyama ² , Ichizo Tsujino ³ , Junichi Nakamura ³ , Naoto Yamamoto ⁴ , Hiroko Nakata ⁵ , Satoshi Ikeda ⁶ , Michihisa Umetsu ⁷ , Shizu Aikawa ⁸ , Hiroya Hayashi ⁹ , Hirono Satokawa ¹⁰ , Yoshinori Okuno ¹¹ , Eriko Iwata ¹² , Yoshito Ogihara ¹³ , Nobutaka Ikeda ¹⁴ , Akane Kondo ¹⁵ , Takehisa Iwai ¹⁶ , Norikazu Yamada ¹⁷ , Tomohiro Ogawa ¹⁸ , Takao Kobayashi ⁴ , Makoto Mo ¹⁹ , Yugo Yamashita ²⁰ , CLOT-COVID Study Investigators



Affiliations

• PMID: 35430141
• DOI: 10.1016/j.jjcc.2022.03.015

Abstract

Background: Data on thrombosis and current real-world management strategies for anticoagulation therapy are scarce but important for understanding current issues and unmet needs of an optimal management of patients with coronavirus disease 2019 (COVID-19).
Method: The CLOT-COVID Study (thrombosis and antiCoaguLatiOn Therapy in patients with COVID-19 in Japan Study: UMIN000045800) was a retrospective, multicenter cohort study enrolling consecutive hospitalized patients with COVID-19 among 16 centers in Japan from April 2021 to September 2021, and we tried to capture the status of the patients in the fourth and fifth waves of the COVID-19 infections in Japan. We enrolled consecutive hospitalized patients who were diagnosed with COVID-19 and had a positive polymerase chain reaction test obtained from the hospital databases.
Results: Among 2894 patients with COVID-19, 1245 (43%) received pharmacological thromboprophylaxis. The proportion of pharmacological thromboprophylaxis increased according to the severity of the COVID-19 in 9.8% with mild COVID-19, 61% with moderate COVID-19, and 97% with severe COVID-19. The types and doses of anticoagulants varied widely across the participating centers. During the hospitalization, 38 patients (1.3%) and 126 (4.4%) underwent ultrasound examinations for the lower extremities and contrast-enhanced computed tomography examinations, respectively, and 55 (1.9%) developed thrombosis, mostly venous thromboembolism (71%). The incidence of thrombosis increased according to the severity of the COVID-19 in 0.2% with mild COVID-19, 1.4% with moderate COVID-19, and 9.5% with severe COVID-19. Major bleeding occurred in 57 patients (2.0%) and 158 (5.5%) died, and 81% of them were due to respiratory failure from COVID-19 pneumonia.
Conclusions: In the present large-scale observational study, pharmacological thromboprophylaxis for hospitalized patients with COVID-19 was common especially in patients with severe COVID-19, and management strategies varied widely across the participating centers. The overall incidence of thrombosis was substantially low with an increased incidence according to the severity of the COVID-19.

Keywords: Anticoagulants; Asian; Coronavirus disease 2019; Japan; Thrombosis.

[sharon sanders]

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