Incidence and Predictors of Thrombotic Complications in 4742 Patients with COVID-19 or Other Acute Infectious Respiratory Diseases: A Propensity Score-Matched Study

Background. A prothrombotic state, attributable to excessive inflammation, cytokine storm, hypoxia, and immobilization, is a feature of SARS-CoV-2 infection. Up to 30% of patients with severe COVID-19 remain at high risk of thromboembolic events despite anticoagulant administration, with adverse imp...

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Autores principales:	Antonio De Vita, Giuseppe De Matteis, Alessia d’Aiello, Salvatore Emanuele Ravenna, Giovanna Liuzzo, Gaetano Antonio Lanza, Massimo Massetti, Filippo Crea, Antonio Gasbarrini, Francesco Franceschi, Marcello Covino
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	acute infectious respiratory disease COVID-19 SARS-CoV-2 infection thrombosis thromboembolic events Medicine R
Acceso en línea:	https://doaj.org/article/131103ef1a8241aabc1f62d501bdd53e
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spelling	oai:doaj.org-article:131103ef1a8241aabc1f62d501bdd53e2021-11-11T17:36:10ZIncidence and Predictors of Thrombotic Complications in 4742 Patients with COVID-19 or Other Acute Infectious Respiratory Diseases: A Propensity Score-Matched Study10.3390/jcm102149732077-0383https://doaj.org/article/131103ef1a8241aabc1f62d501bdd53e2021-10-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/21/4973https://doaj.org/toc/2077-0383Background. A prothrombotic state, attributable to excessive inflammation, cytokine storm, hypoxia, and immobilization, is a feature of SARS-CoV-2 infection. Up to 30% of patients with severe COVID-19 remain at high risk of thromboembolic events despite anticoagulant administration, with adverse impact on in-hospital prognosis. Methods. We retrospectively studied 4742 patients with acute infectious respiratory disease (AIRD); 2579 were diagnosed to have COVID-19 and treated with heparin, whereas 2163 had other causes of AIRD. We compared the incidence and predictors of total, arterial, and venous thrombosis, both in the whole population and in a propensity score-matched subpopulation of 3036 patients (1518 in each group). Results. 271 thrombotic events occurred in the whole population: 121 (4.7%) in the COVID-19 group and 150 (6.9%) in the no-COVID-19 group (<i>p</i> < 0.001). No differences in the incidence of total (<i>p</i> = 0.11), arterial (<i>p</i> = 0.26), and venous (<i>p</i> = 0.38) thrombosis were found between the two groups after adjustment for confounding clinical variables and in the propensity score-matched subpopulation. Likewise, there were no significant differences in bleeding rates between the two groups. Clinical predictors of arterial thrombosis included age (<i>p</i> = 0.006), diabetes mellitus (<i>p</i> = 0.034), peripheral artery disease (<i>p</i> < 0.001), and previous stroke (<i>p</i> < 0.001), whereas history of solid cancer (<i>p</i> < 0.001) and previous deep vein thrombosis (<i>p</i> = 0.007) were associated with higher incidence of venous thrombosis. Conclusions. Hospitalized patients with COVID-19 treated with heparin do not seem to show significant differences in the cumulative incidence of thromboembolic events as well as in the incidence of arterial and venous thrombosis separately, compared with AIRD patients with different etiological diagnosis.Antonio De VitaGiuseppe De MatteisAlessia d’AielloSalvatore Emanuele RavennaGiovanna LiuzzoGaetano Antonio LanzaMassimo MassettiFilippo CreaAntonio GasbarriniFrancesco FranceschiMarcello CovinoMDPI AGarticleacute infectious respiratory diseaseCOVID-19SARS-CoV-2 infectionthrombosisthromboembolic eventsMedicineRENJournal of Clinical Medicine, Vol 10, Iss 4973, p 4973 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	acute infectious respiratory disease COVID-19 SARS-CoV-2 infection thrombosis thromboembolic events Medicine R
spellingShingle	acute infectious respiratory disease COVID-19 SARS-CoV-2 infection thrombosis thromboembolic events Medicine R Antonio De Vita Giuseppe De Matteis Alessia d’Aiello Salvatore Emanuele Ravenna Giovanna Liuzzo Gaetano Antonio Lanza Massimo Massetti Filippo Crea Antonio Gasbarrini Francesco Franceschi Marcello Covino Incidence and Predictors of Thrombotic Complications in 4742 Patients with COVID-19 or Other Acute Infectious Respiratory Diseases: A Propensity Score-Matched Study
description	Background. A prothrombotic state, attributable to excessive inflammation, cytokine storm, hypoxia, and immobilization, is a feature of SARS-CoV-2 infection. Up to 30% of patients with severe COVID-19 remain at high risk of thromboembolic events despite anticoagulant administration, with adverse impact on in-hospital prognosis. Methods. We retrospectively studied 4742 patients with acute infectious respiratory disease (AIRD); 2579 were diagnosed to have COVID-19 and treated with heparin, whereas 2163 had other causes of AIRD. We compared the incidence and predictors of total, arterial, and venous thrombosis, both in the whole population and in a propensity score-matched subpopulation of 3036 patients (1518 in each group). Results. 271 thrombotic events occurred in the whole population: 121 (4.7%) in the COVID-19 group and 150 (6.9%) in the no-COVID-19 group (<i>p</i> < 0.001). No differences in the incidence of total (<i>p</i> = 0.11), arterial (<i>p</i> = 0.26), and venous (<i>p</i> = 0.38) thrombosis were found between the two groups after adjustment for confounding clinical variables and in the propensity score-matched subpopulation. Likewise, there were no significant differences in bleeding rates between the two groups. Clinical predictors of arterial thrombosis included age (<i>p</i> = 0.006), diabetes mellitus (<i>p</i> = 0.034), peripheral artery disease (<i>p</i> < 0.001), and previous stroke (<i>p</i> < 0.001), whereas history of solid cancer (<i>p</i> < 0.001) and previous deep vein thrombosis (<i>p</i> = 0.007) were associated with higher incidence of venous thrombosis. Conclusions. Hospitalized patients with COVID-19 treated with heparin do not seem to show significant differences in the cumulative incidence of thromboembolic events as well as in the incidence of arterial and venous thrombosis separately, compared with AIRD patients with different etiological diagnosis.
format	article
author	Antonio De Vita Giuseppe De Matteis Alessia d’Aiello Salvatore Emanuele Ravenna Giovanna Liuzzo Gaetano Antonio Lanza Massimo Massetti Filippo Crea Antonio Gasbarrini Francesco Franceschi Marcello Covino
author_facet	Antonio De Vita Giuseppe De Matteis Alessia d’Aiello Salvatore Emanuele Ravenna Giovanna Liuzzo Gaetano Antonio Lanza Massimo Massetti Filippo Crea Antonio Gasbarrini Francesco Franceschi Marcello Covino
author_sort	Antonio De Vita
title	Incidence and Predictors of Thrombotic Complications in 4742 Patients with COVID-19 or Other Acute Infectious Respiratory Diseases: A Propensity Score-Matched Study
title_short	Incidence and Predictors of Thrombotic Complications in 4742 Patients with COVID-19 or Other Acute Infectious Respiratory Diseases: A Propensity Score-Matched Study
title_full	Incidence and Predictors of Thrombotic Complications in 4742 Patients with COVID-19 or Other Acute Infectious Respiratory Diseases: A Propensity Score-Matched Study
title_fullStr	Incidence and Predictors of Thrombotic Complications in 4742 Patients with COVID-19 or Other Acute Infectious Respiratory Diseases: A Propensity Score-Matched Study
title_full_unstemmed	Incidence and Predictors of Thrombotic Complications in 4742 Patients with COVID-19 or Other Acute Infectious Respiratory Diseases: A Propensity Score-Matched Study
title_sort	incidence and predictors of thrombotic complications in 4742 patients with covid-19 or other acute infectious respiratory diseases: a propensity score-matched study
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/131103ef1a8241aabc1f62d501bdd53e
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Incidence and Predictors of Thrombotic Complications in 4742 Patients with COVID-19 or Other Acute Infectious Respiratory Diseases: A Propensity Score-Matched Study

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