Data di Pubblicazione:
2023
Abstract:
Background: Complications under anticoagulant treatment in patients with COVID-19-associated venous thromboembolism (VTE) have not been consistently reported. Objectives: This study aimed to compare the 90-day rates of VTE recurrences and major bleeding in patients with COVID-19-associated VTE versus those with VTE without COVID-19. Methods: We used the RIETE registry to compare the 3-month outcomes in patients with COVID-19-associated VTE versus those with VTE without COVID-19. Results: The study included 1,747 patients with COVID-19-associated VTE and 8,711 with VTE without COVID-19. Patients with COVID-19-associated VTE were more likely to be hospitalized at baseline and to present with pulmonary embolism. During the first 90 days, 123 patients (1.17%) developed VTE recurrences, and 266 (2.54%) experienced major bleeding. Patients with COVID-19-associated VTE had a similar rate of VTE recurrences (0.9% vs 1.2%) but a higher rate of major bleeding (4.6% vs 2.1%; P <.001) than those without COVID-19. Multivariable analysis adjusted for competing risks showed that patients with COVID-19-associated VTE had an increased risk of major bleeding (subhazard ratio, 1.395; 95% confidence interval, 1.037-1.877). The 30-day mortality after major bleeding was 26.3% in patients with COVID-19-associated VTE and 17.7% in those without COVID-19. Conclusion: Patients with COVID-19-associated VTE had a 5-fold higher rate of major bleeding than VTE recurrences during the first 90 days of anticoagulation. In VTE patients without COVID-19, both rates were similar. These findings highlight the importance of carefully monitoring and optimizing anticoagulation in these patients.
Tipologia CRIS:
Articolo su Rivista
Keywords:
anticoagulants; COVID-19; hemorrhage; pulmonary embolism; venous thromboembolism
Elenco autori:
Demelo-Rodriguez, P.; Alonso-Beato, R.; Jara-Palomares, L.; Galeano-Valle, F.; Bura-Riviere, A.; Visona, A.; Francisco, I.; Vidal, G.; Lopez-Ruiz, A.; Monreal, M.; Adarraga, M. D.; Alberich-Conesa, A.; Amado, C.; Amoros, S.; Arcelus, J. I.; Ballaz, A.; Barba, R.; Barbagelata, C.; Barron, M.; Barron-Andres, B.; Blanco-Molina, A.; Botella, E.; Carrero, R.; Casado, I.; Criado, J.; del Toro, J.; De Ancos, C.; De Juana-Izquierdo, C.; Demelo-Rodriguez, P.; Diaz-Brasero, A. M.; Diaz-Pedroche, M. C.; Diaz-Peromingo, J. A.; Dubois-Silva, A.; Escribano, J. C.; Esposito, F.; Falga, C.; Farfan-Sedano, A. I.; Fernandez-Capitan, C.; Fernandez-Jimenez, B.; Fernandez-Muixi, J.; Fernandez-Reyes, J. L.; Font, C.; Francisco, I.; Galeano-Valle, F.; Garcia, M. A.; Garcia de Herreros, M.; Garcia-Bragado, F.; Garcia-Ortega, A.; Gavin-Sebastian, O.; Gil-Diaz, A.; Gil-Hernandez, A.; Gomez-Cuervo, C.; Gomez-Mosquera, A. M.; Gonzalez-Martinez, J.; Grau, E.; Guirado, L.; Gutierrez, J.; Hernandez-Blasco, L.; Jaras, M. J.; Jimenez, D.; Jou, I.; Joya, M. D.; Lacruz, B.; Lalueza, A.; Lainez-Justo, S.; Lecumberri, R.; Leon-Ramirez, J. M.; Lobo, J. L.; Lopez-De la Fuente, M.; Lopez-Jimenez, L.; Lopez-Miguel, P.; Lopez-Nunez, J. J.; Lopez-Reyes, R.; Lopez-Ruiz, A.; Lopez-Saez, J. B.; Lorente, M. A.; Lorenzo, A.; Lumbierres, M.; Madridano, O.; Maestre, A.; Mas-Maresma, L.; Marcos, M.; Martin-Guerra, J. M.; Martin-Martos, F.; Mellado, M.; Mena, E.; Mercado, M. I.; Moises, J.; Monreal, M.; Munoz-Blanco, A.; Munoz-Gamito, G.; Nieto, J. A.; Nunez-Fernandez, M. J.; Osorio, J.; Otalora, S.; Pacheco-Gomez, N.; Paredes-Ruiz, D.; Parra, P.; Pedrajas, J. M.; Perez-Ductor, C.; Perez-Jacoiste, A.; Perez-Perez, J. L.; Peris, M. L.; Pesce, M. L.; Porras, J. A.; Poyo-Molina, J.; Puchades, R.; Riera-Mestre, A.; Rivera-Civico, F.; Rivera-Gallego, A.; Roca, M.; Rubio, C. M.; Rosa, V.; Rodriguez-Cobo, A.; Ruiz-Gimenez, N.; Ruiz-Ruiz, J.; Salgueiro, G.; Sancho, T.; Sendin, V.; Siguenza, P.; Soler, S.; Surinach, J. M.; Tiberio, G.; Tolosa, C.; Torres, M. I.; Trujillo-Santos, J.; Uresandi, F.; Usandizaga, E.; Valle, R.; Varona, J. F.; Vela, J. R.; Vela, L.; Vidal, G.; Villalobos, A.; Villares, P.; Ay, C.; Nopp, S.; Pabinger, I.; Engelen, M.; Martens, C.; Verhamme, P.; Yoo, H. H. B.; Arguello, J. D.; Montenegro, A. C.; Roa, J.; Hirmerova, J.; Maly, R.; Accassat, S.; Bertoletti, L.; Bura-Riviere, A.; Catella, J.; Chopard, R.; Couturaud, F.; Espitia, O.; Grange, C.; Leclercq, B.; Le Mao, R.; Mahe, I.; Moustafa, F.; Plaisance, L.; Poenou, G.; Sarlon-Bartoli, G.; Suchon, P.; Versini, E.; Schellong, S.; Braester, A.; Brenner, B.; Kenet, G.; Najib, D.; Tzoran, I.; Farrashi, M.; Sadeghipour, P.; Basaglia, M.; Bilora, F.; Bortoluzzi, C.; Brandolin, B.; Ciammaichella, M.; Colaizzo, D.; Dentali, F.; Di Micco, P.; Grandone, E.; Imbalzano, E.; Merla, S.; Pesavento, R.; Prandoni, P.; Scarinzi, P.; Siniscalchi, C.; Taflaj, B.; Tufano, A.; Visona, A.; Vo Hong, N.; Zalunardo, B.; Fonseca, S.; Manuel, M.; Meireles, J.; Bosevski, M.; Eftimova, A.; Zdraveska, M.; Bounameaux, H.; Mazzolai, L.; Aujayeb, A.; Caprini, J. A.; Weinberg, I.; Bui, H. M.
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