tetano
Editor, Senior Moderator
Intern Emerg Med
. 2021 Jul 4.
doi: 10.1007/s11739-020-02621-8. Online ahead of print.
Arterial and venous thrombosis in coronavirus 2019 disease (Covid-19): relationship with mortality
Francesco Violi[SUP] 1 2 [/SUP], Giancarlo Ceccarelli[SUP] 3 [/SUP], Roberto Cangemi[SUP] 4 [/SUP], Francesco Cipollone[SUP] 5 [/SUP], Damiano D'Ardes[SUP] 5 [/SUP], Alessandra Oliva[SUP] 3 [/SUP], Matteo Pirro[SUP] 6 [/SUP], Monica Rocco[SUP] 7 [/SUP], Francesco Alessandri[SUP] 8 [/SUP], Gabriella D'Ettorre[SUP] 3 [/SUP], Miriam Lichtner[SUP] 3 [/SUP], Pasquale Pignatelli[SUP] 9 10 [/SUP], Domenico Ferro[SUP] 9 [/SUP], Franco Ruberto[SUP] 8 [/SUP], Gregory Y H Lip[SUP] 11 12 [/SUP], Francesco Pugliese[SUP] 8 [/SUP], Claudio Maria Mastroianni[SUP] 3 [/SUP], Intensive Care, Infectious Diseases COVID-19 Study Group of Sapienza University
Collaborators, Affiliations
Abstract
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
: 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.
Keywords: Covid-19; Mortality; SARS-cov-2; Thrombosis.
. 2021 Jul 4.
doi: 10.1007/s11739-020-02621-8. Online ahead of print.
Arterial and venous thrombosis in coronavirus 2019 disease (Covid-19): relationship with mortality
Francesco Violi[SUP] 1 2 [/SUP], Giancarlo Ceccarelli[SUP] 3 [/SUP], Roberto Cangemi[SUP] 4 [/SUP], Francesco Cipollone[SUP] 5 [/SUP], Damiano D'Ardes[SUP] 5 [/SUP], Alessandra Oliva[SUP] 3 [/SUP], Matteo Pirro[SUP] 6 [/SUP], Monica Rocco[SUP] 7 [/SUP], Francesco Alessandri[SUP] 8 [/SUP], Gabriella D'Ettorre[SUP] 3 [/SUP], Miriam Lichtner[SUP] 3 [/SUP], Pasquale Pignatelli[SUP] 9 10 [/SUP], Domenico Ferro[SUP] 9 [/SUP], Franco Ruberto[SUP] 8 [/SUP], Gregory Y H Lip[SUP] 11 12 [/SUP], Francesco Pugliese[SUP] 8 [/SUP], Claudio Maria Mastroianni[SUP] 3 [/SUP], Intensive Care, Infectious Diseases COVID-19 Study Group of Sapienza University
Collaborators, Affiliations
- PMID: 34218413
- DOI: 10.1007/s11739-020-02621-8
Abstract
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
: 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.
Keywords: Covid-19; Mortality; SARS-cov-2; Thrombosis.