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Arterial and venous thrombosis in coronavirus 2019 disease (Covid-19): relationship with mortality.
Violi, Francesco; Ceccarelli, Giancarlo; Cangemi, Roberto; Cipollone, Francesco; D'Ardes, Damiano; Oliva, Alessandra; Pirro, Matteo; Rocco, Monica; Alessandri, Francesco; D'Ettorre, Gabriella; Lichtner, Miriam; Pignatelli, Pasquale; Ferro, Domenico; Ruberto, Franco; Lip, Gregory Y H; Pugliese, Francesco; Mastroianni, Claudio Maria.
  • Violi F; I Clinica Medica, Department of Clinical Internal, Anaesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161, Roma, Italy. francesco.violi@uniroma1.it.
  • Ceccarelli G; Mediterranea Cardiocentro, Naples, Italy. francesco.violi@uniroma1.it.
  • Cangemi R; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
  • Cipollone F; Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.
  • D'Ardes D; Clinica Medica, Department of Medicine and Aging, "G. D'Annunzio, University of Chieti-Pescara, Chieti, Italy.
  • Oliva A; Clinica Medica, Department of Medicine and Aging, "G. D'Annunzio, University of Chieti-Pescara, Chieti, Italy.
  • Pirro M; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
  • Rocco M; Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, Italy.
  • Alessandri F; Dipartimento Emergenza E Accettazione, Ospedale Universitario Sant'Andrea, Rome, Italy.
  • D'Ettorre G; Department of General Surgery Paride Stefanini, Sapienza University of Rome, Rome, Italy.
  • Lichtner M; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
  • Pignatelli P; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
  • Ferro D; I Clinica Medica, Department of Clinical Internal, Anaesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161, Roma, Italy.
  • Ruberto F; Mediterranea Cardiocentro, Naples, Italy.
  • Lip GYH; I Clinica Medica, Department of Clinical Internal, Anaesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161, Roma, Italy.
  • Pugliese F; Department of General Surgery Paride Stefanini, Sapienza University of Rome, Rome, Italy.
  • Mastroianni CM; Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.
Intern Emerg Med ; 16(5): 1231-1237, 2021 08.
Article in English | MEDLINE | ID: covidwho-1293431
ABSTRACT

BACKGROUND:

Patients with coronavirus disease 2019 (Covid-19) may experience venous thrombosis while data regarding arterial thrombosis are sparse.

METHODS:

Prospective multicenter study in 5 hospitals including 373 patients with Covid-19-related pneumonia. Demographic data, laboratory findings including coagulation tests and comorbidities were reported. During the follow-up any arterial or venous thrombotic events and death were registered.

RESULTS:

Among 373 patients, 75 (20%) had a thrombotic event and 75 (20%) died. Thrombotic events included 41 venous thromboembolism and 34 arterial thrombosis. Age, cardiovascular disease, intensive care unit treatment, white blood cells, D-dimer, albumin and troponin blood levels were associated with thrombotic events. In a multivariable regression logistic model, intensive care unit treatment (Odds Ratio [OR] 6.0; 95% Confidence Interval [CI] 2.8-12.6; p < 0.001); coronary artery disease (OR 2.4; 95% CI 1.4-5.0; p = 0.022); and albumin levels (OR 0.49; 95% CI 0.28-0.87; p = 0.014) were associated with ischemic events. Age, sex, chronic obstructive pulmonary disease, diabetes, heart failure, coronary heart disease, intensive care unit treatment, in-hospital thrombotic events, D-dimer, C-reactive protein, troponin, and albumin levels were associated with mortality. A multivariable Cox regression analysis showed that in-hospital thrombotic events (hazard ratio [HR] 2.72; 95% CI 1.59-4.65; p < 0.001), age (HR 1.035; 95% CI 1.014-1.057; p = 0.001), and albumin (HR 0.447; 95% CI 0.277-0.723; p = 0.001) predicted morality.

CONCLUSIONS:

Covid-19 patients experience an equipollent rate of venous and arterial thrombotic events, that are associated with poor survival. Early identification and appropriate treatment of Covid-19 patients at risk of thrombosis may improve prognosis.
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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Thromboembolism / Coronary Artery Disease / Mortality / COVID-19 Subject: Thromboembolism / Coronary Artery Disease / Mortality / COVID-19 Type of study: Controlled clinical trial / Etiology study / Observational study / Prognostic study / Risk factors Language: English Journal: Intern Emerg Med Clinical aspect: Etiology / Prediction / Prognosis Year: 2021

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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Thromboembolism / Coronary Artery Disease / Mortality / COVID-19 Subject: Thromboembolism / Coronary Artery Disease / Mortality / COVID-19 Type of study: Controlled clinical trial / Etiology study / Observational study / Prognostic study / Risk factors Language: English Journal: Intern Emerg Med Clinical aspect: Etiology / Prediction / Prognosis Year: 2021
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