Tags

Type your tag names separated by a space and hit enter

Registry of Arterial and Venous Thromboembolic Complications in Patients With COVID-19.
J Am Coll Cardiol. 2020 11 03; 76(18):2060-2072.JACC

Abstract

BACKGROUND

Cardiovascular complications, including myocardial infarction, ischemic stroke, and pulmonary embolism, represent an important source of adverse outcomes in coronavirus disease-2019 (COVID-19).

OBJECTIVES

To assess the frequency of arterial and venous thromboembolic disease, risk factors, prevention and management patterns, and outcomes in patients with COVID-19, the authors designed a multicenter, observational cohort study.

METHODS

We analyzed a retrospective cohort of 1,114 patients with COVID-19 diagnosed through our Mass General Brigham integrated health network. The total cohort was analyzed by site of care: intensive care (n = 170); hospitalized nonintensive care (n = 229); and outpatient (n = 715). The primary study outcome was a composite of adjudicated major arterial or venous thromboembolism.

RESULTS

Patients with COVID-19 were 22.3% Hispanic/Latinx and 44.2% non-White. Cardiovascular risk factors of hypertension (35.8%), hyperlipidemia (28.6%), and diabetes (18.0%) were common. Prophylactic anticoagulation was prescribed in 89.4% of patients with COVID-19 in the intensive care cohort and 84.7% of those in the hospitalized nonintensive care setting. Frequencies of major arterial or venous thromboembolism, major cardiovascular adverse events, and symptomatic venous thromboembolism were highest in the intensive care cohort (35.3%, 45.9%, and 27.0 %, respectively) followed by the hospitalized nonintensive care cohort (2.6%, 6.1%, and 2.2%, respectively) and the outpatient cohort (0% for all).

CONCLUSIONS

Major arterial or venous thromboembolism, major adverse cardiovascular events, and symptomatic venous thromboembolism occurred with high frequency in patients with COVID-19, especially in the intensive care setting, despite a high utilization rate of thromboprophylaxis.

Authors+Show Affiliations

Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: gpiazza@partners.org.Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.Division of Infectious Diseases, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.Department of Pharmacy, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

33121712

Citation

Piazza, Gregory, et al. "Registry of Arterial and Venous Thromboembolic Complications in Patients With COVID-19." Journal of the American College of Cardiology, vol. 76, no. 18, 2020, pp. 2060-2072.
Piazza G, Campia U, Hurwitz S, et al. Registry of Arterial and Venous Thromboembolic Complications in Patients With COVID-19. J Am Coll Cardiol. 2020;76(18):2060-2072.
Piazza, G., Campia, U., Hurwitz, S., Snyder, J. E., Rizzo, S. M., Pfeferman, M. B., Morrison, R. B., Leiva, O., Fanikos, J., Nauffal, V., Almarzooq, Z., & Goldhaber, S. Z. (2020). Registry of Arterial and Venous Thromboembolic Complications in Patients With COVID-19. Journal of the American College of Cardiology, 76(18), 2060-2072. https://doi.org/10.1016/j.jacc.2020.08.070
Piazza G, et al. Registry of Arterial and Venous Thromboembolic Complications in Patients With COVID-19. J Am Coll Cardiol. 2020 11 3;76(18):2060-2072. PubMed PMID: 33121712.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Registry of Arterial and Venous Thromboembolic Complications in Patients With COVID-19. AU - Piazza,Gregory, AU - Campia,Umberto, AU - Hurwitz,Shelley, AU - Snyder,Julia E, AU - Rizzo,Samantha M, AU - Pfeferman,Mariana B, AU - Morrison,Ruth B, AU - Leiva,Orly, AU - Fanikos,John, AU - Nauffal,Victor, AU - Almarzooq,Zaid, AU - Goldhaber,Samuel Z, PY - 2020/06/03/received PY - 2020/08/26/revised PY - 2020/08/29/accepted PY - 2020/10/30/entrez PY - 2020/10/31/pubmed PY - 2020/11/6/medline KW - COVID-19 KW - anticoagulation KW - cardiovascular disease KW - coronavirus KW - deep venous thrombosis KW - myocardial infarction KW - pulmonary embolism KW - stroke KW - thromboembolism SP - 2060 EP - 2072 JF - Journal of the American College of Cardiology JO - J Am Coll Cardiol VL - 76 IS - 18 N2 - BACKGROUND: Cardiovascular complications, including myocardial infarction, ischemic stroke, and pulmonary embolism, represent an important source of adverse outcomes in coronavirus disease-2019 (COVID-19). OBJECTIVES: To assess the frequency of arterial and venous thromboembolic disease, risk factors, prevention and management patterns, and outcomes in patients with COVID-19, the authors designed a multicenter, observational cohort study. METHODS: We analyzed a retrospective cohort of 1,114 patients with COVID-19 diagnosed through our Mass General Brigham integrated health network. The total cohort was analyzed by site of care: intensive care (n = 170); hospitalized nonintensive care (n = 229); and outpatient (n = 715). The primary study outcome was a composite of adjudicated major arterial or venous thromboembolism. RESULTS: Patients with COVID-19 were 22.3% Hispanic/Latinx and 44.2% non-White. Cardiovascular risk factors of hypertension (35.8%), hyperlipidemia (28.6%), and diabetes (18.0%) were common. Prophylactic anticoagulation was prescribed in 89.4% of patients with COVID-19 in the intensive care cohort and 84.7% of those in the hospitalized nonintensive care setting. Frequencies of major arterial or venous thromboembolism, major cardiovascular adverse events, and symptomatic venous thromboembolism were highest in the intensive care cohort (35.3%, 45.9%, and 27.0 %, respectively) followed by the hospitalized nonintensive care cohort (2.6%, 6.1%, and 2.2%, respectively) and the outpatient cohort (0% for all). CONCLUSIONS: Major arterial or venous thromboembolism, major adverse cardiovascular events, and symptomatic venous thromboembolism occurred with high frequency in patients with COVID-19, especially in the intensive care setting, despite a high utilization rate of thromboprophylaxis. SN - 1558-3597 UR - https://www.unboundmedicine.com/medline/citation/33121712/Registry_of_Arterial_and_Venous_Thromboembolic_Complications_in_Patients_With_COVID_19_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735-1097(20)36590-6 DB - PRIME DP - Unbound Medicine ER -