tetano
Editor, Senior Moderator
Angiology
. 2023 Apr 2;33197231167055.
doi: 10.1177/00033197231167055. Online ahead of print.
Risk Factors, Clinical Presentation, Therapeutic Trends, and Outcomes in Arterial Thrombosis Complicating Unvaccinated COVID-19 Patients: A Systematic Review
Alejandra Castro-Varela[SUP] 1 [/SUP], Daniela M Martinez-Magallanes[SUP] 1 [/SUP], Maria Fernanda Reyes-Chavez[SUP] 1 2 [/SUP], Jose Manuel Gonzalez-Rayas[SUP] 1 [/SUP], Jose Gildardo Paredes-Vazquez[SUP] 1 3 [/SUP], Eduardo Vazquez-Garza[SUP] 1 2 [/SUP], Mauricio Castillo-Perez[SUP] 1 [/SUP], Yoezer Z Flores-Sayavedra[SUP] 1 [/SUP], Arturo Martinez[SUP] 1 [/SUP], Ray Erick Ramos Cazares[SUP] 1 [/SUP], Jaime Guajardo[SUP] 1 [/SUP], Hector Lopez-de la Garza[SUP] 1 [/SUP], Jose Alfredo Salinas-Casanova[SUP] 1 [/SUP], Hector Betancourt[SUP] 1 [/SUP], Abigail Montserrat Molina-Rodriguez[SUP] 1 [/SUP], Jathniel Panneflek[SUP] 2 [/SUP], Mario Alejandro Fabiani[SUP] 3 [/SUP], Carlos Jerjes-Sanchez[SUP] 1 2 3 [/SUP]
Affiliations
Abstract
Data on characteristics and outcomes of coronavirus (COVID)-19 patients complicated with arterial thrombosis (AT) are scarce. Therefore, we carried out a systematic review (PRISMA, PROSPERO statements; PubMed, Scopus, and Web of Science) to identify risk factors, clinical presentation, treatment, and outcomes. We included publications from December 2019 to October 2020. Groups: (a) ischemic stroke, (b) thrombotic storm, (c) peripheral vascular thrombosis, (d) myocardial infarction, and (e) left cardiac thrombus or in-transit thrombus (venous system thrombus floating or attaching to the right heart). We considered 131 studies. The most frequent cardiovascular risk factors were: hypertension, diabetes, and dyslipidemia. A high proportion presented with asymptomatic, mild, or moderate COVID-19 (n = 91, 41.4%). We identified a high percentage of isolated ischemic stroke and thrombotic storm. Groups with higher mortality rate: intracardiac thrombus (1/2, 50.0%), thrombotic storm (18/49, 36.7%), and ischemic stroke (48/131, 36.6%). A small number received thromboprophylaxis. Most patients received antithrombotic treatment. The most frequent bleeding complication was intracranial hemorrhage, primarily with isolated stroke. Overall mortality was 33.6% (74/220). Despite a wide range of COVID-19 severity, a high proportion had AT as a complication of non-severe disease. AT can affect different vascular territories; mortality is associated with stroke, intensive care unit stay, and severe COVID-19.
Keywords: COVID-19; acute myocardial infarction; anticoagulation; arterial thrombosis; coronavirus; peripheral artery disease; stroke; thrombolysis; thrombotic storm.
. 2023 Apr 2;33197231167055.
doi: 10.1177/00033197231167055. Online ahead of print.
Risk Factors, Clinical Presentation, Therapeutic Trends, and Outcomes in Arterial Thrombosis Complicating Unvaccinated COVID-19 Patients: A Systematic Review
Alejandra Castro-Varela[SUP] 1 [/SUP], Daniela M Martinez-Magallanes[SUP] 1 [/SUP], Maria Fernanda Reyes-Chavez[SUP] 1 2 [/SUP], Jose Manuel Gonzalez-Rayas[SUP] 1 [/SUP], Jose Gildardo Paredes-Vazquez[SUP] 1 3 [/SUP], Eduardo Vazquez-Garza[SUP] 1 2 [/SUP], Mauricio Castillo-Perez[SUP] 1 [/SUP], Yoezer Z Flores-Sayavedra[SUP] 1 [/SUP], Arturo Martinez[SUP] 1 [/SUP], Ray Erick Ramos Cazares[SUP] 1 [/SUP], Jaime Guajardo[SUP] 1 [/SUP], Hector Lopez-de la Garza[SUP] 1 [/SUP], Jose Alfredo Salinas-Casanova[SUP] 1 [/SUP], Hector Betancourt[SUP] 1 [/SUP], Abigail Montserrat Molina-Rodriguez[SUP] 1 [/SUP], Jathniel Panneflek[SUP] 2 [/SUP], Mario Alejandro Fabiani[SUP] 3 [/SUP], Carlos Jerjes-Sanchez[SUP] 1 2 3 [/SUP]
Affiliations
- PMID: 37005343
- DOI: 10.1177/00033197231167055
Abstract
Data on characteristics and outcomes of coronavirus (COVID)-19 patients complicated with arterial thrombosis (AT) are scarce. Therefore, we carried out a systematic review (PRISMA, PROSPERO statements; PubMed, Scopus, and Web of Science) to identify risk factors, clinical presentation, treatment, and outcomes. We included publications from December 2019 to October 2020. Groups: (a) ischemic stroke, (b) thrombotic storm, (c) peripheral vascular thrombosis, (d) myocardial infarction, and (e) left cardiac thrombus or in-transit thrombus (venous system thrombus floating or attaching to the right heart). We considered 131 studies. The most frequent cardiovascular risk factors were: hypertension, diabetes, and dyslipidemia. A high proportion presented with asymptomatic, mild, or moderate COVID-19 (n = 91, 41.4%). We identified a high percentage of isolated ischemic stroke and thrombotic storm. Groups with higher mortality rate: intracardiac thrombus (1/2, 50.0%), thrombotic storm (18/49, 36.7%), and ischemic stroke (48/131, 36.6%). A small number received thromboprophylaxis. Most patients received antithrombotic treatment. The most frequent bleeding complication was intracranial hemorrhage, primarily with isolated stroke. Overall mortality was 33.6% (74/220). Despite a wide range of COVID-19 severity, a high proportion had AT as a complication of non-severe disease. AT can affect different vascular territories; mortality is associated with stroke, intensive care unit stay, and severe COVID-19.
Keywords: COVID-19; acute myocardial infarction; anticoagulation; arterial thrombosis; coronavirus; peripheral artery disease; stroke; thrombolysis; thrombotic storm.