Incidence and determinants of venous thromboembolism over 90 days in hospitalized and nonhospitalized patients with COVID-19.

Autor: Tholin B; Clinic of Internal Medicine, Østfold Hospital, Grålum, Norway.; Institute of Clinical Medicine, University of Oslo, Oslo, Norway., Ghanima W; Clinic of Internal Medicine, Østfold Hospital, Grålum, Norway.; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.; Department of Haematology, Oslo University Hospital, Oslo, Norway., Selle ML; Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway., Stavem K; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.; Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway.; Department of Pulmonary Medicine, Akershus University Hospital, Lørenskog, Norway.
Jazyk: angličtina
Zdroj: Journal of internal medicine [J Intern Med] 2023 Dec; Vol. 294 (6), pp. 721-729. Date of Electronic Publication: 2023 Jul 30.
DOI: 10.1111/joim.13706
Abstrakt: Introduction: COVID-19 is associated with an increased risk of venous thromboembolism (VTE), but there is great variation among reported incidence rates. Most previous studies have focused on hospitalized patients with COVID-19, and only a few reports are from population-based registries.
Methods: We studied the 90-day incidence of VTE, associated risk factors and all-cause mortality in hospitalized and nonhospitalized patients with COVID-19 in a nationwide cohort. Data on hospitalizations and outpatient visits were extracted from two national registries with mandatory reporting linked by a unique national identification number carried by all Norwegian residents. We performed Cox proportional hazards regression to determine risk factors for VTE after infection with SARS-CoV-2.
Results: Our study included 30,495 patients with positive SARS-CoV-2 polymerase chain reaction with a mean (SD) age of 41.9 (17.3) years, and 53% were males. Only 2081 (6.8%) were hospitalized. The 90-day incidence of VTE was 0.3% (95% CI: 0.21-0.33) overall and 2.9% (95% CI: 2.3-3.7) in hospitalized patients. Age (hazard ratio [HR] 1.28 per decade, 95% CI: 1.11-1.48, p < 0.05), history of previous VTE (HR 4.69, 95% CI: 2.34-9.40, p < 0.05), and hospitalization for COVID-19 (HR 23.83, 95% CI: 13.48-42.13, p < 0.05) were associated with risk of VTE.
Conclusions: The 90-day incidence of VTE in hospitalized and nonhospitalized patients with COVID-19 was in the lower end compared with previous reports, with considerably higher rates in hospitalized than nonhospitalized patients. Risk factors for VTE were consistent with previously reported studies.
(© 2023 The Authors. Journal of Internal Medicine published by John Wiley & Sons Ltd on behalf of Association for Publication of The Journal of Internal Medicine.)
Databáze: MEDLINE
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