Arterial Thrombotic Events in Adult Inpatients With COVID-19
| Autor: | Pascale Nicaise Roland, Philippe Gabriel Steg, Laurène Deconinck, A. Dossier, Nadine Ajzenberg, Jean-François Timsit, Thomas Papo, Céline Guidoux, Christophe Choquet, Vincent Descamps, Quentin Pellenc, Camille Taillé, Morgane Fournier, Vincent Bunel, François Xavier Lescure, Dorothée Faille, Brice Lortat-Jacob, Tiphaine Goulenok, Raphael Borie, Pierre Mutuon, Diane Descamps, Philippa C. Lavallée, Lila Bouadma, Nathalie Faucher, Yazdan Yazdanpanah, Yves Castier, Gregory Ducrocq, Antoine Khalil, Bruno Crestani, Hervé Mal, Philippe Dieudé, Eric Daugas, Arthur Mageau, Karim Sacre |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
CRP C reactive protein CT computerized tomography ICD international classification of disease 030204 cardiovascular system & hematology AT arterial thrombotic events RT-PCR reverse transcriptase polymerase chain reaction 0302 clinical medicine Risk Factors 030212 general & internal medicine COVID-19 coronavirus disease 2019 biology LDH lactate dehydrogenase Medical record Mortality rate Hazard ratio General Medicine Middle Aged Thrombosis Hospitalization Cardiology WHO world health organization Female Original Article medicine.medical_specialty CVE cardiovascular events 03 medical and health sciences medicine.artery Internal medicine D-dimer medicine Humans IQR interquartile range Aged Retrospective Studies Aorta business.industry C-reactive protein COVID-19 arterial thrombotic events Retrospective cohort study medicine.disease HR hazard ratio OR odds ratio in-hospital death biology.protein business SARS-CoV-2 severe acute respiratory syndrome coronavirus-2 |
| Zdroj: | Mayo Clinic Proceedings |
| ISSN: | 1942-5546 0025-6196 |
| Popis: | Objective To evaluate the clinical course of and risk factors for arterial thrombotic events in adult inpatients with coronavirus disease 2019 (COVID-19). Methods All consecutive adult patients admitted for COVID-19 infection in a referral center in France and discharged from the hospital between April 1 and April 30, 2020, were included. All arterial thrombotic events that occurred through discharge were considered for analysis. Epidemiologic, demographic, clinical, laboratory, treatment, and outcome data were extracted from electronic medical records with use of a standardized data collection form. Results Overall, 531 COVID-19+ patients were analyzed. Among them, 30 (5.6%) experienced arterial thrombotic events. Arterial thrombotic events in the setting of COVID-19 infection happened at a median of 11 (5-20) days after the first symptoms of infection; occurred in high-risk patients according to traditional cardiovascular risk factors; had an atypical pattern, such as thrombosis of the aorta, upper limb, or renal arteries or cerebral microvasculopathy in 7 (23.3%) cases; and were associated with an in-hospital mortality rate of 40%. Arterial thrombotic events increased the risk of death by 3-fold in COVID-19+ patients (hazard ratio, 2.96; 95% CI, 1.4 to 4.7; P=.002). A subdistribution survival hazard model showed that a concentration of D-dimer above 1250 ng/mL increased the risk of arterial thrombotic events in COVID-19+ patients by more than 7 (subdistribution hazard ratio, 7.68; 95% CI, 2.9 to 20.6; P Conclusion A dramatically high rate of in-hospital death was observed in patients who suffered arterial thrombotic events in the setting of COVID-19 infection. A D-dimer level above 1250 ng/mL at entry may identify COVID-19+ patients at risk for arterial thrombotic events. |
| Databáze: | OpenAIRE |
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