High rate of bleeding and arterial thrombosis in COVID-19: Saudi multicenter study
Abstract Background Several observational studies have reported the rate of venous and arterial thrombotic events in patients infected with COVID-19, with conflicting results. The aim of this study was to estimate the rate of thrombotic and bleeding events in hospitalized patients diagnosed with Cor...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-03-01
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| Series: | Thrombosis Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12959-021-00265-y |
| _version_ | 1828927974506758144 |
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| author | Abdulrahman Al Raizah Ahmed Al Askar Naila Shaheen Khalid Aldosari Mohamed Alnahdi Musumadi Luhanga Turki Alshuaibi Wail Bajhmoum Khaled Alharbi Ghaida Alsahari Hadeel Algahtani Eunice Alrayes Abdulrahim Basendwah Alia Abotaleb Mosaad Almegren |
| author_facet | Abdulrahman Al Raizah Ahmed Al Askar Naila Shaheen Khalid Aldosari Mohamed Alnahdi Musumadi Luhanga Turki Alshuaibi Wail Bajhmoum Khaled Alharbi Ghaida Alsahari Hadeel Algahtani Eunice Alrayes Abdulrahim Basendwah Alia Abotaleb Mosaad Almegren |
| author_sort | Abdulrahman Al Raizah |
| collection | DOAJ |
| description | Abstract Background Several observational studies have reported the rate of venous and arterial thrombotic events in patients infected with COVID-19, with conflicting results. The aim of this study was to estimate the rate of thrombotic and bleeding events in hospitalized patients diagnosed with Coronavirus disease 2019 (COVID-19). Methods This was a multicenter study of 636 patients admitted between 20 March 2020 and 31 May 2020 with confirmed COVID-19 in four hospitals. Results Over a median length of stay in the non-ICU group of 7 days and of 19 days in the ICU group, twelve patients were diagnosed with Venous thromboembolism (VTE) (1.8 %) (95 % CI, 1.1–3). The rate in the non-ICU group was 0.19 % (95 % CI, 0.04–0.84), and that in the ICU group was 10.3 % (95 % CI, 6.4–16.2). The overall rate of arterial event is 2.2 % (95 % CI, 1.4–3.3). The rates in the non-ICU and ICU groups were 0.94 % (95 % CI, 0.46–0.1.9) and 8.4 % (95 % CI, 5.0–14.0). The overall composite event rate was 2.9 % (95 % CI, 2.0–4.3). The composite event rates in the non-ICU and ICU groups were 0.94 % (95 % CI, 0.46–0.1.9) and 13.2 % (95 % CI, 8.7–19.5). The overall rate of bleeding is 1.7 % (95 % CI, 1.0–2.8). The bleeding rate in the non-ICU group was 0.19 % (95 % CI, 0.04–0.84), and that in the ICU group was 9.4 % (95 % CI, 5.7–15.1). The baseline D-dimer level was a significant risk factor for developing VTE (OR 1.31, 95 % CI, 1.08–1.57, p = 0.005) and composite events (OR 1.32, 95 % CI, 1.12–1.55, p = 0.0007). Conclusions In this study, we found that the VTE rates in hospitalized patients with COVID-19 might not be higher than expected. In contrast to the risk of VTE, we found a high rate of arterial and bleeding complications in patients admitted to the ICU. An elevated D-dimer level at baseline could predict thrombotic complications in COVID-19 patients and may assist in the identification of these patients. Given the high rate of bleeding, the current study suggests that the intensification of anticoagulation therapy in COVID-19 patients beyond the standard of care be pursued with caution and would best be evaluated in a randomized controlled study. |
| first_indexed | 2024-12-13T23:57:33Z |
| format | Article |
| id | doaj.art-59dd9379a6f346ba86e279263224de24 |
| institution | Directory Open Access Journal |
| issn | 1477-9560 |
| language | English |
| last_indexed | 2024-12-13T23:57:33Z |
| publishDate | 2021-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Thrombosis Journal |
| spelling | doaj.art-59dd9379a6f346ba86e279263224de242022-12-21T23:26:29ZengBMCThrombosis Journal1477-95602021-03-011911910.1186/s12959-021-00265-yHigh rate of bleeding and arterial thrombosis in COVID-19: Saudi multicenter studyAbdulrahman Al Raizah0Ahmed Al Askar1Naila Shaheen2Khalid Aldosari3Mohamed Alnahdi4Musumadi Luhanga5Turki Alshuaibi6Wail Bajhmoum7Khaled Alharbi8Ghaida Alsahari9Hadeel Algahtani10Eunice Alrayes11Abdulrahim Basendwah12Alia Abotaleb13Mosaad Almegren14Division of Adult Hematology, Department of Oncology, King Abdulaziz Medical City, Ministry of National Guard Health AffairsDivision of Adult Hematology, Department of Oncology, King Abdulaziz Medical City, Ministry of National Guard Health AffairsKing Saud bin Abdulaziz University of Health SciencesDivision of Adult Hematology, Department of Oncology, King Abdulaziz Medical City, Ministry of National Guard Health AffairsDivision of Adult Hematology, Department of Oncology, King Abdulaziz Medical City, Ministry of National Guard Health AffairsDivision of Adult Hematology, Department of Oncology, King Abdulaziz Medical City, Ministry of National Guard Health AffairsDepartment of Medicine, King Fahd HospitalDepartment of Medicine, King Fahd HospitalDepartment of Medicine, King Fahd HospitalDepartment of Medicine, King Fahd HospitalDepartment of Medicine, King Fahd HospitalDepartment of Medicine, Prince Mohammed Bin Abdulaziz HospitalOncology Division, Medicine Department, King Fahad Armed Forces HospitalOncology Division, Medicine Department, King Fahad Armed Forces HospitalDepartment of Medicine, College of Medicine, Imam Mohammad Ibn Saud Islamic UniversityAbstract Background Several observational studies have reported the rate of venous and arterial thrombotic events in patients infected with COVID-19, with conflicting results. The aim of this study was to estimate the rate of thrombotic and bleeding events in hospitalized patients diagnosed with Coronavirus disease 2019 (COVID-19). Methods This was a multicenter study of 636 patients admitted between 20 March 2020 and 31 May 2020 with confirmed COVID-19 in four hospitals. Results Over a median length of stay in the non-ICU group of 7 days and of 19 days in the ICU group, twelve patients were diagnosed with Venous thromboembolism (VTE) (1.8 %) (95 % CI, 1.1–3). The rate in the non-ICU group was 0.19 % (95 % CI, 0.04–0.84), and that in the ICU group was 10.3 % (95 % CI, 6.4–16.2). The overall rate of arterial event is 2.2 % (95 % CI, 1.4–3.3). The rates in the non-ICU and ICU groups were 0.94 % (95 % CI, 0.46–0.1.9) and 8.4 % (95 % CI, 5.0–14.0). The overall composite event rate was 2.9 % (95 % CI, 2.0–4.3). The composite event rates in the non-ICU and ICU groups were 0.94 % (95 % CI, 0.46–0.1.9) and 13.2 % (95 % CI, 8.7–19.5). The overall rate of bleeding is 1.7 % (95 % CI, 1.0–2.8). The bleeding rate in the non-ICU group was 0.19 % (95 % CI, 0.04–0.84), and that in the ICU group was 9.4 % (95 % CI, 5.7–15.1). The baseline D-dimer level was a significant risk factor for developing VTE (OR 1.31, 95 % CI, 1.08–1.57, p = 0.005) and composite events (OR 1.32, 95 % CI, 1.12–1.55, p = 0.0007). Conclusions In this study, we found that the VTE rates in hospitalized patients with COVID-19 might not be higher than expected. In contrast to the risk of VTE, we found a high rate of arterial and bleeding complications in patients admitted to the ICU. An elevated D-dimer level at baseline could predict thrombotic complications in COVID-19 patients and may assist in the identification of these patients. Given the high rate of bleeding, the current study suggests that the intensification of anticoagulation therapy in COVID-19 patients beyond the standard of care be pursued with caution and would best be evaluated in a randomized controlled study.https://doi.org/10.1186/s12959-021-00265-ySARS-CoV-2COVID-19CoronavirusBleedingThrombosisVenous thromboembolism |
| spellingShingle | Abdulrahman Al Raizah Ahmed Al Askar Naila Shaheen Khalid Aldosari Mohamed Alnahdi Musumadi Luhanga Turki Alshuaibi Wail Bajhmoum Khaled Alharbi Ghaida Alsahari Hadeel Algahtani Eunice Alrayes Abdulrahim Basendwah Alia Abotaleb Mosaad Almegren High rate of bleeding and arterial thrombosis in COVID-19: Saudi multicenter study Thrombosis Journal SARS-CoV-2 COVID-19 Coronavirus Bleeding Thrombosis Venous thromboembolism |
| title | High rate of bleeding and arterial thrombosis in COVID-19: Saudi multicenter study |
| title_full | High rate of bleeding and arterial thrombosis in COVID-19: Saudi multicenter study |
| title_fullStr | High rate of bleeding and arterial thrombosis in COVID-19: Saudi multicenter study |
| title_full_unstemmed | High rate of bleeding and arterial thrombosis in COVID-19: Saudi multicenter study |
| title_short | High rate of bleeding and arterial thrombosis in COVID-19: Saudi multicenter study |
| title_sort | high rate of bleeding and arterial thrombosis in covid 19 saudi multicenter study |
| topic | SARS-CoV-2 COVID-19 Coronavirus Bleeding Thrombosis Venous thromboembolism |
| url | https://doi.org/10.1186/s12959-021-00265-y |
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