COVID-19 and Risk of VTE in Ethnically Diverse Populations
| Autor: | Alan S. Go, Cecilia Portugal, Sue Hee Sung, Elisha Garcia, Margaret C. Fang, Grace H. Tabada, Dongjie Fan, Kristi Reynolds, Ashok P. Pai, Priya A. Prasad |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine medicine.medical_specialty Adolescent venous thromboembolism VTE venous thromboembolism Critical Care and Intensive Care Medicine California Young Adult Internal medicine Epidemiology Ethnicity medicine Humans Risk factor Young adult Pandemics Aged Retrospective Studies Original Research Aged 80 and over LAPS2 Laboratory-Based Acute Physiology Score Version 2 Risk Management Covid-19 coronavirus disease 2019 SARS-CoV-2 business.industry Hazard ratio COVID-19 EMR electronic medical record Retrospective cohort study Middle Aged medicine.disease Hospitals Pulmonary embolism risk factor Pacific islanders Female epidemiology VDW Virtual Data Warehouse Diagnosis code Cardiology and Cardiovascular Medicine business |
| Zdroj: | Chest |
| ISSN: | 0012-3692 |
| DOI: | 10.1016/j.chest.2021.07.025 |
| Popis: | Background Limited existing data suggest that the novel COVID-19 may increase risk of VTE, but information from large, ethnically diverse populations with appropriate control participants is lacking. Research Question Does the rate of VTE among adults hospitalized with COVID-19 differ from matched hospitalized control participants without COVID-19? Study Design and Methods We conducted a retrospective study among hospitalized adults with laboratory-confirmed COVID-19 and hospitalized adults without evidence of COVID-19 matched for age, sex, race or ethnicity, acute illness severity, and month of hospitalization between January 2020 and August 2020 from two integrated health care delivery systems with 36 hospitals. Outcomes included VTE (DVT or pulmonary embolism ascertained using diagnosis codes combined with validated natural language processing algorithms applied to electronic health records) and death resulting from any cause at 30 days. Fine and Gray hazards regression was performed to evaluate the association of COVID-19 with VTE after accounting for competing risk of death and residual differences between groups, as well as to identify predictors of VTE in patients with COVID-19. Results We identified 6,319 adults with COVID-19 and 6,319 matched adults without COVID-19, with mean ± SD age of 60.0 ± 17.2 years, 46% women, 53.1% Hispanic, 14.6% Asian/Pacific Islander, and 10.3% Black. During 30-day follow-up, 313 validated cases of VTE (160 COVID-19, 153 control participants) and 1,172 deaths (817 in patients with COVID-19, 355 in control participants) occurred. Adults with COVID-19 showed a more than threefold adjusted risk of VTE (adjusted hazard ratio, 3.48; 95% CI, 2.03-5.98) compared with matched control participants. Predictors of VTE in patients with COVID-19 included age ≥ 55 years, Black race, prior VTE, diagnosed sepsis, prior moderate or severe liver disease, BMI ≥ 40 kg/m2, and platelet count > 217 k/μL. Interpretation Among ethnically diverse hospitalized adults, COVID-19 infection increased the risk of VTE, and selected patient characteristics were associated with higher thromboembolic risk in the setting of COVID-19. |
| Databáze: | OpenAIRE |
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