Arterial and venous thrombosis in coronavirus 2019 disease (Covid-19): relationship with mortality

Medientyp: E-Artikel
Titel: Arterial and venous thrombosis in coronavirus 2019 disease (Covid-19): relationship with mortality
Beteiligte: Violi, Francesco; Ceccarelli, Giancarlo; Cangemi, Roberto; Cipollone, Francesco; D’Ardes, Damiano; Oliva, Alessandra; Pirro, Matteo; Rocco, Monica; Alessandri, Francesco; D’Ettorre, Gabriella; Lichtner, Miriam; Pignatelli, Pasquale; Ferro, Domenico; Ruberto, Franco; Lip, Gregory Y. H.; Pugliese, Francesco; Mastroianni, Claudio Maria; Pugliese, Francesco; Alessandri, Francesco; Ruberto, Franco; Albante, Alida; Auricchio, Daniela; De Lazzaro, Francesco; M. De Lauri, Daniela; [...]
Erschienen: Springer Science and Business Media LLC, 2021
Erschienen in: Internal and Emergency Medicine
Sprache: Englisch
DOI: 10.1007/s11739-020-02621-8
ISSN: 1828-0447; 1970-9366
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Beschreibung: <jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p>Patients with coronavirus disease 2019 (Covid-19) may experience venous thrombosis while data regarding arterial thrombosis are sparse.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>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.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>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; <jats:italic>p</jats:italic> < 0.001); coronary artery disease (OR: 2.4; 95% CI 1.4–5.0; <jats:italic>p</jats:italic> = 0.022); and albumin levels (OR: 0.49; 95% CI 0.28–0.87; <jats:italic>p</jats:italic> = 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 [HR]: 2.72; 95% CI 1.59–4.65; <jats:italic>p</jats:italic> < 0.001), age (HR: 1.035; 95% CI 1.014–1.057; <jats:italic>p</jats:italic> = 0.001), and albumin (HR: 0.447; 95% CI 0.277–0.723; <jats:italic>p</jats:italic> = 0.001) predicted morality.</jats:p> </jats:sec><jats:sec> <jats:title>Conclusions</jats:title> <jats:p>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.</jats:p> </jats:sec>

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