在整个COVID-19时代进行静脉血栓栓塞管理:解决急性和长期挑战
Maddalena Alessandra Wu1,2, Alba Taino1, Pietro Facchinetti3
1Division of Internal Medicine, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, University of Milan, 20156 Milan, Italy.
Journal of clinical medicine
|March 28, 2024
概括
与非COVID-19患者相比,患有静脉血栓塞栓症 (VTE) 的COVID-19患者表现出较少的并发症和较低的死亡率. 管理涉及COVID-19相关的VTE较短的抗凝血疗程,在这个群体中没有观察到死亡.
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:
- COVID-19与通过免疫血栓机制增加静脉血栓栓塞 (VTE) 的风险有关.
- 有限的数据比较了COVID-19和非COVID-19患者之间的VTE管理和急性和长期随访结果.
研究的目的:
- 研究和比较COVID-19患者和没有COVID-19患者的VTE急性和长期管理和并发症.
主要方法:
- 前性,观察性,单中心的队列研究.
- 从急性治疗到诊断后24个月的VTE患者的随访.
- 与COVID-19相关的VTE和非COVID-19的VTE队列之间的临床特征,治疗和结果的比较.
主要成果:
- 招募了157名患者 (30名COVID-19,127名非COVID-19患者),平均随访时间为10.8个月.
- 在COVID-19患者中,伴随性疾病较少,在基线时肺栓塞的比例较高,并且在三个月后继续接受抗凝治疗的可能性较低.
- 在COVID-19患者中没有死亡事件发生,与非COVID-19组的9.4%死亡率形成对比 (p=0.027). 主要出血事件和VTE复发率在各组之间是相似的.
结论:
- 与COVID-19相关的VTE患者表现出明显的临床特征和结果,包括显著降低死亡率.
- 个性化,基于风险的方法对于VTE管理至关重要,可能涉及COVID-19患者较短的抗凝血疗程.
- 对针对不同VTE风险子组的定制抗凝策略进行进一步的研究是有必要的.
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