在COVID-19的住院患者中,静脉血栓栓塞事件的预测因素
Giovanni Scimeca1,2, Darsiya Krishnathasan1,3, Sina Rashedi1,3
1Thrombosis Research Group, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Journal of thrombosis and thrombolysis
|March 11, 2025
概括
COVID-19患者面临更高的静脉血栓栓塞 (VTE) 风险. 以前的VTE,皮质类固醇使用和血栓形成症增加了VTE风险,而抗凝药和他类药物降低了风险.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 血液学 血液学 血液学
背景情况:
- 住院COVID-19患者患有静脉血栓栓塞 (VTE) 的风险较高.
- 之前确定VTE预测因子的研究受到小样本规模和行政数据的限制.
- 冠状病毒-VTE网络提供了一个强大的数据集,用于调查COVID-19中VTE风险因素.
研究的目的:
- 确定确诊COVID-19的住院患者中VTE的预测因素.
- 分析各种临床因素与VTE风险之间的关联.
- 为COVID-19患者的风险评估策略提供信息.
主要方法:
- 利用了多中心CORONA-VTE网络注册表中的3844名成年患者的数据.
- 主要结局:在90天内一次性判断肺栓塞或深静脉血栓形成.
- 采用了因果特定的考克斯回归分析与聚合危险比率 (HRs).
主要成果:
- 在90天内,VTE的累积发病率为5.3%.
- 与之前的VTE (HR: 1.71),皮质类固醇治疗 (HR: 1.76) 和血栓友 (HR: 3.56) 相关的VTE风险增加.
- 与治疗性抗凝药 (HR:0.42),他类药物使用 (HR:0.67) 和预防性抗凝药 (HR:0.52) 相关的VTE风险降低.
结论:
- 在COVID-19患者中确定了与VTE风险相关的关键临床因素.
- 以前的静脉动脉瘤,皮质类固醇和血栓形成是危险因素.
- 抗凝药和他类药物显示出对VTE的保护作用.
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