tetano
Editor, Senior Moderator
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[SUP] 1 [/SUP], Sen Yachi[SUP] 2 [/SUP], Makoto Takeyama[SUP] 2 [/SUP], Ichizo Tsujino[SUP] 3 [/SUP], Junichi Nakamura[SUP] 3 [/SUP], Naoto Yamamoto[SUP] 4 [/SUP], Hiroko Nakata[SUP] 5 [/SUP], Satoshi Ikeda[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] 4 [/SUP], Makoto Mo[SUP] 19 [/SUP], Yugo Yamashita[SUP] 20 [/SUP], CLOT-COVID Study Investigators
Affiliations
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.
. 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[SUP] 1 [/SUP], Sen Yachi[SUP] 2 [/SUP], Makoto Takeyama[SUP] 2 [/SUP], Ichizo Tsujino[SUP] 3 [/SUP], Junichi Nakamura[SUP] 3 [/SUP], Naoto Yamamoto[SUP] 4 [/SUP], Hiroko Nakata[SUP] 5 [/SUP], Satoshi Ikeda[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] 4 [/SUP], Makoto Mo[SUP] 19 [/SUP], Yugo Yamashita[SUP] 20 [/SUP], 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.
