与COVID-19相关的静脉血栓栓塞:复发和严重出血的风险
Pablo Demelo-Rodriguez1, Rubén Alonso-Beato1, Luis Jara-Palomares2
1Internal Medicine Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Research and practice in thrombosis and haemostasis
|October 16, 2023
概括
与没有COVID-19的患者相比,患有COVID-19相关的静脉血栓塞栓症 (VTE) 的患者在抗凝时面临更高的重大出血风险. 仔细监测对于优化这些高风险患者的治疗至关重要.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 血液学 血液学 血液学
背景情况:
- 在COVID-19相关的静脉血栓塞栓症 (VTE) 中,抗凝剂治疗的并发症需要进一步调查.
- 现有的关于该患者群体出血和复发率的数据不一致.
研究的目的:
- 为了比较90天VTE复发率和重大出血.
- 为了评估COVID-19相关的VTE患者与没有COVID-19的患者之间的结果.
主要方法:
- 使用RIETE注册表进行比较分析.
- 包括1,747名COVID-19相关的VTE患者和8,711名没有.
- 比较3个月后的结果,包括VTE复发和严重出血.
主要成果:
- 与COVID-19相关的VTE患者有类似的VTE复发率 (0.9%对1.2%) 但明显更高的重大出血率 (4.6%对2.1%;P<.001).
- 多变量分析显示,COVID-19相关的VTE患者有较大的出血风险增加 (SHR,1.395;95%CI,1.037-1.877).
- 大型出血后的30天死亡率在COVID-19组中较高 (26.3%对17.7%).
结论:
- 与COVID-19相关的VTE患者的严重出血率比90天内VTE复发率高5倍.
- 这凸显了对COVID-19相关的VTE患者的抗凝血监测和管理的关键需求.
- 优化抗凝策略对于减轻该群体出血风险至关重要.
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