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Venous Thromboembolism and Major Bleeding in Patients With Coronavirus Disease 2019 (COVID-19): A Nationwide, Population-Based Cohort Study.
Dalager-Pedersen, Michael; Lund, Lars Christian; Mariager, Theis; Winther, Rannva; Hellfritzsch, Maja; Larsen, Torben Bjerregaard; Thomsen, Reimar Wernich; Johansen, Nanna Borup; Søgaard, Ole Schmeltz; Nielsen, Stig Lønberg; Omland, Lars Haukali; Lundbo, Lene Fogt; Israelsen, Simone Bastrup; Harboe, Zitta Barrella; Pottegård, Anton; Nielsen, Henrik; Bodilsen, Jacob.
  • Dalager-Pedersen M; Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark.
  • Lund LC; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
  • Mariager T; Clinical Pharmacology and Pharmacy, University of Southern Denmark, Odense C, Denmark.
  • Winther R; Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark.
  • Hellfritzsch M; Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark.
  • Larsen TB; Clinical Pharmacology and Pharmacy, University of Southern Denmark, Odense C, Denmark.
  • Thomsen RW; Department of Clinical Pharmacology, Aarhus University Hospital, Aarhus C, Denmark.
  • Johansen NB; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
  • Søgaard OS; Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.
  • Nielsen SL; Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark.
  • Omland LH; Department of Clinical Evaluation and Biostatistics, Danish Medicines Agency, Copenhagen, Denmark.
  • Lundbo LF; Department of Infectious Diseases, Aarhus University Hospital, Aarhus N, Denmark.
  • Israelsen SB; Department of Infectious Diseases, Odense University Hospital, Odense C, Denmark.
  • Harboe ZB; Research Unit for Infectious Diseases, Odense University Hospital, Odense, Denmark.
  • Pottegård A; University of Southern Denmark, Odense, Denmark.
  • Nielsen H; Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
  • Bodilsen J; Center of Research & Disruption of Infectious Diseases (CREDID), Department of Infectious Diseases, Copenhagen University Hospitals, Hvidovre, Denmark.
Clin Infect Dis ; 73(12): 2283-2293, 2021 12 16.
Article in English | MEDLINE | ID: covidwho-1592629
ABSTRACT

BACKGROUND:

Venous thromboembolism (VTE) is a potentially fatal complication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and thromboprophylaxis should be balanced against risk of bleeding. This study examined risks of VTE and major bleeding in hospitalized and community-managed SARS-CoV-2 patients compared with control populations.

METHODS:

Using nationwide population-based registries, 30-day risks of VTE and major bleeding in SARS-CoV-2 positive patients were compared with those of SARS-CoV-2 test-negative patients and with an external cohort of influenza patients. Medical records of all COVID-19 patients at 6 departments of infectious diseases in Denmark were reviewed in detail.

RESULTS:

The overall 30-day risk of VTE was 0.4% (40/9460) among SARS-CoV-2 patients (16% hospitalized), 0.3% (649/226 510) among SARS-CoV-2 negative subjects (12% hospitalized), and 1.0% (158/16 281) among influenza patients (59% hospitalized). VTE risks were higher and comparable in hospitalized SARS-CoV-2 positive (1.5%), SARS-CoV-2 negative (1.8%), and influenza patients (1.5%). Diagnosis of major bleeding was registered in 0.5% (47/9460) of all SARS-CoV-2 positive individuals and in 2.3% of those hospitalized. Medical record review of 582 hospitalized SARS-CoV-2 patients observed VTE in 4% (19/450) and major bleeding in 0.4% (2/450) of ward patients, of whom 31% received thromboprophylaxis. Among intensive care patients (100% received thromboprophylaxis), risks were 7% (9/132) for VTE and 11% (15/132) for major bleeding.

CONCLUSIONS:

Among people with SARS-CoV-2 infection in a population-based setting, VTE risks were low to moderate and were not substantially increased compared with SARS-CoV-2 test-negative and influenza patients. Risk of severe bleeding was low for ward patients, but mirrored VTE risk in the intensive care setting.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Venous Thromboembolism / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Limits: Humans Language: English Journal: Clin Infect Dis Journal subject: Communicable Diseases Year: 2021 Document Type: Article Affiliation country: Cid

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Venous Thromboembolism / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Limits: Humans Language: English Journal: Clin Infect Dis Journal subject: Communicable Diseases Year: 2021 Document Type: Article Affiliation country: Cid