COVID-19 is associated with higher risk of venous thrombosis, but not arterial thrombosis, compared with influenza: Insights from a large US cohort

Autor: Sanchit Gad, Fatima Rodriguez, Rajesh Dash, Andrew Ward, Mac Bonafede, Ashish Sarraju, Robert Beetel, Kanchan Bhasin, Donghyun Lee, Stella Chang
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Male
Viral Diseases
Epidemiology
Deep vein
Cardiovascular Medicine
Vascular Medicine
Cohort Studies
Medical Conditions
Risk Factors
Medicine and Health Sciences
Myocardial infarction
Aged
80 and over
Venous Thrombosis
Multidisciplinary
Hazard ratio
Venous Thromboembolism
Hematology
Middle Aged
Thrombosis
Pulmonary embolism
Deep Vein Thrombosis
Stroke
Venous thrombosis
Infectious Diseases
medicine.anatomical_structure
Neurology
Cardiovascular Diseases
Cohort
Medicine
Female
Research Article
Adult
medicine.medical_specialty
Cerebrovascular Diseases
Science
Cardiology
Article
Young Adult
Thromboembolism
Internal medicine
Influenza
Human
medicine
Humans
Propensity Score
Blood Coagulation
Aged
Ischemic Stroke
Proportional Hazards Models
Retrospective Studies
Coagulation Disorders
SARS-CoV-2
business.industry
COVID-19
Covid 19
Retrospective cohort study
medicine.disease
Influenza
United States
Medical Risk Factors
business
Zdroj: PLoS ONE, Vol 17, Iss 1 (2022)
medRxiv
article-version (status) pre
article-version (number) 1
PLoS ONE
PLoS ONE, Vol 17, Iss 1, p e0261786 (2022)
ISSN: 1932-6203
Popis: Introduction Infection with SARS-CoV-2 is typically compared with influenza to contextualize its health risks. SARS-CoV-2 has been linked with coagulation disturbances including arterial thrombosis, leading to considerable interest in antithrombotic therapy for Coronavirus Disease 2019 (COVID-19). However, the independent thromboembolic risk of SARS-CoV-2 infection compared with influenza remains incompletely understood. We evaluated the adjusted risks of thromboembolic events after a diagnosis of COVID-19 compared with influenza in a large retrospective cohort. Methods We used a US-based electronic health record (EHR) dataset linked with insurance claims to identify adults diagnosed with COVID-19 between April 1, 2020 and October 31, 2020. We identified influenza patients diagnosed between October 1, 2018 and April 31, 2019. Primary outcomes [venous composite of pulmonary embolism (PE) and acute deep vein thrombosis (DVT); arterial composite of ischemic stroke and myocardial infarction (MI)] and secondary outcomes were assessed 90 days post-diagnosis. Propensity scores (PS) were calculated using demographic, clinical, and medication variables. PS-adjusted hazard ratios (HRs) were calculated using Cox proportional hazards regression. Results There were 417,975 COVID-19 patients (median age 57y, 61% women), and 345,934 influenza patients (median age 47y, 66% women). Compared with influenza, patients with COVID-19 had higher venous thromboembolic risk (HR 1.53, 95% CI 1.38–1.70), but not arterial thromboembolic risk (HR 1.02, 95% CI 0.95–1.10). Secondary analyses demonstrated similar risk for ischemic stroke (HR 1.11, 95% CI 0.98–1.25) and MI (HR 0.93, 95% CI 0.85–1.03) and higher risk for DVT (HR 1.36, 95% CI 1.19–1.56) and PE (HR 1.82, 95% CI 1.57–2.10) in patients with COVID-19. Conclusion In a large retrospective US cohort, COVID-19 was independently associated with higher 90-day risk for venous thrombosis, but not arterial thrombosis, as compared with influenza. These findings may inform crucial knowledge gaps regarding the specific thromboembolic risks of COVID-19.
Databáze: OpenAIRE
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