Late thrombotic complications after SARS‐CoV ‐2 infection in hemodialysis patients
| Autor: | Clara Cases-Corona, Katia López-Revuelta, Enrique Gruss, Karina R. Furaz-Czerpak, Gema Fernández-Juárez, Amir Shabaka, Eugenia Landaluce-Triska, Javier Ocaña, Eduardo Gallego-Valcarce, Ana M. Tato-Ribera |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment 030232 urology & nephrology 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Renal Dialysis COVID‐19 Internal medicine medicine Humans Renal replacement therapy Stroke Retrospective Studies SARS-CoV-2 business.industry Acute kidney injury Anticoagulants COVID-19 Thrombosis Retrospective cohort study Original Articles Hematology medicine.disease stroke Pulmonary embolism Nephrology Cohort Original Article Hemodialysis business renal replacement therapy chronic kidney disease |
| Zdroj: | Hemodialysis International. International Symposium on Home Hemodialysis |
| ISSN: | 1542-4758 1492-7535 |
| Popis: | Introduction There is an increased risk of thrombotic complications in patients with COVID‐19. Hemodialysis patients are already at an increased risk for thromboembolic events such as stroke and pulmonary embolism. The aim of our study was to determine the incidence of late thrombotic complications (deep vein thrombosis, pulmonary embolism, stroke, new‐onset vascular access thrombosis) in maintenance hemodialysis patients after recovery from COVID‐19. Methods We performed a retrospective cohort study of 200 prevalent hemodialysis patients in our center at the start of the pandemic. We excluded incident patients after the cohort entry date and those who required hemodialysis for acute kidney injury, and excluded patients with less than 1 month follow‐up due to kidney transplantation or death from non‐thrombotic causes. Findings One‐hundred and eighty five prevalent hemodialysis patients finally met the inclusion criteria; 37 patients (17.6%) had SARS‐CoV‐2 infection, out of which 10 (27%) died during the acute phase of disease without evidence of thrombotic events. There was an increased risk of thrombotic events in COVID‐19 survivors compared to the non‐infected cohort (18.5% vs. 1.9%, p = 0.002) after a median follow‐up of 7 months. Multivariate regression analysis showed that COVID‐19 infection increased risk for late thrombotic events adjusted for age, sex, hypertension, diabetes, antithrombotic treatment, and previous thrombotic events (Odds Ratio (OR) 26.4, 95% confidence interval 2.5–280.6, p = 0.01). Clinical and laboratory markers did not predict thrombotic events. Conclusions There is an increased risk of late thrombotic complications in hemodialysis patients after infection with COVID‐19. Further studies should evaluate the benefit of prolonged prophylactic anticoagulation in hemodialysis patients after recovery from COVID‐19. |
| Databáze: | OpenAIRE |
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