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Comparison of Thrombotic Events and Mortality in Patients with Community-Acquired Pneumonia and COVID-19: A Multicenter Observational Study.
Cangemi, Roberto; Calvieri, Camilla; Falcone, Marco; Cipollone, Francesco; Ceccarelli, Giancarlo; Pignatelli, Pasquale; D'Ardes, Damiano; Pirro, Matteo; Alessandri, Francesco; Lichtner, Miriam; D'Ettorre, Gabriella; Oliva, Alessandra; Aronica, Raissa; Rocco, Monica; Venditti, Mario; Romiti, Giulio Francesco; Tiseo, Giusy; Taliani, Gloria; Menichetti, Francesco; Pugliese, Francesco; Mastroianni, Claudio Maria; Violi, Francesco.
  • Cangemi R; Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.
  • Calvieri C; Department of Clinical Internal, I Clinica Medica, Anaesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy.
  • Falcone M; Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
  • Cipollone F; Department of Medicine and Aging, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.
  • Ceccarelli G; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
  • Pignatelli P; Department of Clinical Internal, I Clinica Medica, Anaesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy.
  • D'Ardes D; Mediterranea Cardiocentro, Naples, Italy.
  • Pirro M; Department of Medicine and Aging, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.
  • Alessandri F; Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, Italy.
  • Lichtner M; Department of General Surgery Paride Stefanini, Sapienza University of Rome, Rome, Italy.
  • D'Ettorre G; Infectious Diseases Unit, Santa Maria Goretti Hospital, Sapienza University of Rome, Latina, Italy.
  • Oliva A; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
  • Aronica R; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
  • Rocco M; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
  • Venditti M; Department of Clinical and Surgical Translational Medicine, Sant' Andrea Hospital, Sapienza University of Rome, Rome, Italy.
  • Romiti GF; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
  • Tiseo G; Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.
  • Taliani G; Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
  • Menichetti F; Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.
  • Pugliese F; Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
  • Mastroianni CM; Department of General Surgery Paride Stefanini, Sapienza University of Rome, Rome, Italy.
  • Violi F; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
Thromb Haemost ; 122(2): 257-266, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1592074
ABSTRACT

BACKGROUND:

It is still unclear if patients with community-acquired pneumonia (CAP) and coronavirus disease 2019 (COVID-19) have different rate, typology, and impact of thrombosis on survival.

METHODS:

In this multicenter observational cohort study, 1,138 patients, hospitalized for CAP (n = 559) or COVID-19 (n = 579) from seven clinical centers in Italy, were included in the study. Consecutive adult patients (age ≥ 18 years) with confirmed COVID-19-related pneumonia, with or without mechanical ventilation, hospitalized from March 1, 2020 to April 30, 2020, were enrolled. COVID-19 was diagnosed based on the World Health Organization interim guidance. Patients were followed-up until discharge or in-hospital death, registering the occurrence of thrombotic events including ischemic/embolic events.

RESULTS:

During the in-hospital stay, 11.4% of CAP and 15.5% of COVID-19 patients experienced thrombotic events (p = 0.046). In CAP patients all the events were arterial thromboses, while in COVID-19 patients 8.3% were venous and 7.2% arterial thromboses.During the in-hospital follow-up, 3% of CAP patients and 17% of COVID-19 patients died (p < 0.001). The highest mortality rate was found among COVID-19 patients with thrombotic events (47.6 vs. 13.4% in thrombotic-event-free patients; p < 0.001). In CAP, 13.8% of patients experiencing thrombotic events died versus 1.8% of thrombotic event-free ones (p < 0.001). A multivariable Cox-regression analysis confirmed a higher risk of death in COVID-19 patients with thrombotic events (hazard ratio 2.1; 95% confidence interval 1.4-3.3; p < 0.001).

CONCLUSION:

Compared with CAP, COVID-19 is characterized by a higher burden of thrombotic events, different thrombosis typology and higher risk of thrombosis-related in-hospital mortality.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia / Thrombosis / Community-Acquired Infections / SARS-CoV-2 / COVID-19 Type of study: Controlled clinical trial / Etiology study / Clinical Practice Guide / Incidence study / Observational study / Risk factors Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Thromb Haemost Year: 2022 Document Type: Article Affiliation country: A-1692-9939

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia / Thrombosis / Community-Acquired Infections / SARS-CoV-2 / COVID-19 Type of study: Controlled clinical trial / Etiology study / Clinical Practice Guide / Incidence study / Observational study / Risk factors Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: Thromb Haemost Year: 2022 Document Type: Article Affiliation country: A-1692-9939