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Risk Factors and Impact on Outcomes of Thrombosis in Patients with COVID-19 in Japan: From the CLOT-COVID Study
Sen Yachi1, Makoto Takeyama1, Yuji Nishimoto2
1Japan Community Health care Organization Tokyo Shinjuku Medical Center, Tokyo, Japan.
Insights
Thrombosis in hospitalized COVID-19 patients in Japan significantly increased mortality and bleeding risk. Key risk factors included male sex, elevated D-dimer, and severe COVID-19 status.
Area of Science:
- Medical research
- Infectious diseases
- Cardiology
Background:
- The link between thrombotic events and prognosis in Japanese COVID-19 patients remains unclear.
- Investigating clinical outcomes and thrombosis risk factors in hospitalized COVID-19 patients is crucial.
Purpose of the Study:
- To examine the clinical outcomes and identify risk factors for thrombosis in hospitalized COVID-19 patients in Japan.
Main Methods:
- A large-scale analysis of the CLOT-COVID study data was conducted.
- Patient characteristics and outcomes were compared between those with thrombosis (N=55) and without (N=2839).
- Thrombosis encompassed venous thromboembolism, ischemic stroke, myocardial infarction, and systemic arterial thromboembolism.
Main Results:
- Patients with COVID-19 and thrombosis exhibited higher mortality (23.6% vs. 5.1%) and major bleeding rates (23.6% vs. 1.6%) compared to those without.
- Independent risk factors for thrombosis included male sex, D-dimer levels >1.0 µg/mL on admission, and moderate to severe COVID-19 status.
Conclusions:
- Thrombosis development in hospitalized COVID-19 patients is associated with increased mortality and major bleeding.
- Identifying independent risk factors can aid in tailoring patient-specific treatments for COVID-19.
Abstract:
Objectives: The relationship between the thrombotic event and prognosis in patients with coronavirus disease 2019 (COVID-19) has not yet been fully investigated in Japan. Our study aimed to investigate the clinical outcomes and risk factors for thrombosis in hospitalized patients with COVID-19 in Japan. Materials and Methods: We compared the patient characteristics and clinical outcomes among patients with thrombosis (N=55) and those without thrombosis (N=2839) by using a large-scale data of CLOT-COVID study (thrombosis and antiCoaguLatiOn Therapy in patients with COVID-19 in Japan Study: UMIN000045800). Thrombosis included venous thromboembolism, ischemic stroke, myocardial infarction, and systemic arterial thromboembolism. Results: Higher rates of mortality and bleeding events were shown in hospitalized patients with COVID-19 with thrombosis compared to those without thrombosis (all-cause mortality, 23.6% vs. 5.1%, P<0.001; major bleeding, 23.6% vs. 1.6%, P<0.001). Multivariable analysis revealed that the independent risk factors of thrombosis were male sex, D-dimer level on admission>1.0 µg/mL, and moderate and severe COVID-19 status on admission. Conclusions: The development of thrombosis in hospitalized patients with COVID-19 was related to higher mortality and major bleeding, and several independent risk factors for thrombosis could help determine the patient-appropriate treatment for COVID-19.
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