tetano
Editor, Senior Moderator
Circ J
. 2022 Jul 1.
doi: 10.1253/circj.CJ-22-0252. Online ahead of print.
Association Between the Development of Thrombosis and Worsening of Disease Severity in Patients With Moderate COVID-19 on Admission - From the CLOT-COVID Study
Satoshi Ikeda[SUP] 1 [/SUP], Yuki Ueno[SUP] 1 [/SUP], Koji Maemura[SUP] 1 [/SUP], Sen Yachi[SUP] 2 [/SUP], Makoto Takeyama[SUP] 2 [/SUP], Yuji Nishimoto[SUP] 3 [/SUP], Ichizo Tsujino[SUP] 4 [/SUP], Junichi Nakamura[SUP] 4 [/SUP], Naoto Yamamoto[SUP] 5 [/SUP], Hiroko Nakata[SUP] 6 [/SUP], Michihisa Umetsu[SUP] 7 [/SUP], Shizu Aikawa[SUP] 8 [/SUP], Hiroya Hayashi[SUP] 9 [/SUP], Hirono Satokawa[SUP] 10 [/SUP], Yoshinori Okuno[SUP] 11 [/SUP], Eriko Iwata[SUP] 12 [/SUP], Yoshito Ogihara[SUP] 13 [/SUP], Nobutaka Ikeda[SUP] 14 [/SUP], Akane Kondo[SUP] 15 [/SUP], Takehisa Iwai[SUP] 16 [/SUP], Norikazu Yamada[SUP] 17 [/SUP], Tomohiro Ogawa[SUP] 18 [/SUP], Takao Kobayashi[SUP] 5 [/SUP], Makoto Mo[SUP] 19 [/SUP], Yugo Yamashita[SUP] 11 [/SUP], CLOT-COVID Study Investigators
Affiliations
Abstract
Background: The worsening of coronavirus disease 2019 (COVID-19) severity is a critical issue in current clinical settings and may be associated with the development of thrombosis.Methods and Results: This study used patient data obtained in the CLOT-COVID study, a retrospective multicenter cohort study. The demographics of patients with moderate COVID-19 on admission with and without worsened severity during hospitalization were compared and predictors were identified. Of 927 patients with moderate COVID-19 on admission, 182 (19.6%) had worsened severity during hospitalization. Patients with worsening of severity were older, more likely to have hypertension, diabetes, heart disease, and active cancer, and more likely to use pharmacological thromboprophylaxis. Patients with worsening of severity had higher D-dimer levels on admission and were more likely to develop thrombosis and major bleeding during hospitalization than those without worsening. Increased age (odds ratio [OR]: 1.02, 95% confidence interval [CI]: 1.01-1.03, P=0.005), diabetes (OR: 1.63, 95% CI: 1.11-2.33, P=0.012), D-dimer levels >1.0 μg/mL on admission (OR: 2.10, 95% CI: 1.45-3.03, P<0.001), and thrombosis (OR: 6.28, 95% CI: 2.72-14.53, P<0.001) were independently associated with worsening of COVID-19 severity.
Conclusions: Approximately 20% of patients with moderate COVID-19 had worsened severity during hospitalization. Increased age, diabetes, D-dimer levels >1.0 μg/mL on admission, and the development of thrombosis during hospitalization were significantly associated with worsened COVID-19 severity.
Keywords: COVID-19; D-dimer; Thrombosis; Worsening of the severity.
. 2022 Jul 1.
doi: 10.1253/circj.CJ-22-0252. Online ahead of print.
Association Between the Development of Thrombosis and Worsening of Disease Severity in Patients With Moderate COVID-19 on Admission - From the CLOT-COVID Study
Satoshi Ikeda[SUP] 1 [/SUP], Yuki Ueno[SUP] 1 [/SUP], Koji Maemura[SUP] 1 [/SUP], Sen Yachi[SUP] 2 [/SUP], Makoto Takeyama[SUP] 2 [/SUP], Yuji Nishimoto[SUP] 3 [/SUP], Ichizo Tsujino[SUP] 4 [/SUP], Junichi Nakamura[SUP] 4 [/SUP], Naoto Yamamoto[SUP] 5 [/SUP], Hiroko Nakata[SUP] 6 [/SUP], Michihisa Umetsu[SUP] 7 [/SUP], Shizu Aikawa[SUP] 8 [/SUP], Hiroya Hayashi[SUP] 9 [/SUP], Hirono Satokawa[SUP] 10 [/SUP], Yoshinori Okuno[SUP] 11 [/SUP], Eriko Iwata[SUP] 12 [/SUP], Yoshito Ogihara[SUP] 13 [/SUP], Nobutaka Ikeda[SUP] 14 [/SUP], Akane Kondo[SUP] 15 [/SUP], Takehisa Iwai[SUP] 16 [/SUP], Norikazu Yamada[SUP] 17 [/SUP], Tomohiro Ogawa[SUP] 18 [/SUP], Takao Kobayashi[SUP] 5 [/SUP], Makoto Mo[SUP] 19 [/SUP], Yugo Yamashita[SUP] 11 [/SUP], CLOT-COVID Study Investigators
Affiliations
- PMID: 35786694
- DOI: 10.1253/circj.CJ-22-0252
Abstract
Background: The worsening of coronavirus disease 2019 (COVID-19) severity is a critical issue in current clinical settings and may be associated with the development of thrombosis.Methods and Results: This study used patient data obtained in the CLOT-COVID study, a retrospective multicenter cohort study. The demographics of patients with moderate COVID-19 on admission with and without worsened severity during hospitalization were compared and predictors were identified. Of 927 patients with moderate COVID-19 on admission, 182 (19.6%) had worsened severity during hospitalization. Patients with worsening of severity were older, more likely to have hypertension, diabetes, heart disease, and active cancer, and more likely to use pharmacological thromboprophylaxis. Patients with worsening of severity had higher D-dimer levels on admission and were more likely to develop thrombosis and major bleeding during hospitalization than those without worsening. Increased age (odds ratio [OR]: 1.02, 95% confidence interval [CI]: 1.01-1.03, P=0.005), diabetes (OR: 1.63, 95% CI: 1.11-2.33, P=0.012), D-dimer levels >1.0 μg/mL on admission (OR: 2.10, 95% CI: 1.45-3.03, P<0.001), and thrombosis (OR: 6.28, 95% CI: 2.72-14.53, P<0.001) were independently associated with worsening of COVID-19 severity.
Conclusions: Approximately 20% of patients with moderate COVID-19 had worsened severity during hospitalization. Increased age, diabetes, D-dimer levels >1.0 μg/mL on admission, and the development of thrombosis during hospitalization were significantly associated with worsened COVID-19 severity.
Keywords: COVID-19; D-dimer; Thrombosis; Worsening of the severity.