Venous or arterial thrombosis and mortality among COVID-19 cases: a European network cohort study
<p><strong>Background:</strong> There are limited data on the incidence of thrombosis among COVID-19 cases, with most research concentrated on hospitalised patients. We estimated the incidence of venous thromboembolism (VTE), arterial thromboembolism (ATE), and death among COVID-19...
| Huvudupphovsmän: | , , , , , , , , |
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| Materialtyp: | Journal article |
| Språk: | English |
| Publicerad: |
Elsevier
2022
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| _version_ | 1826310272423297024 |
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| author | Burn, E Duarte-Salles, T Fernandez-Bertolin, S Reyes, C Kostka, K Delmestri, A Rijnbeek, P Verhamme, K Prieto-Alhambra, D |
| author_facet | Burn, E Duarte-Salles, T Fernandez-Bertolin, S Reyes, C Kostka, K Delmestri, A Rijnbeek, P Verhamme, K Prieto-Alhambra, D |
| author_sort | Burn, E |
| collection | OXFORD |
| description | <p><strong>Background:</strong> There are limited data on the incidence of thrombosis among COVID-19 cases, with most research concentrated on hospitalised patients. We estimated the incidence of venous thromboembolism (VTE), arterial thromboembolism (ATE), and death among COVID-19 cases; and to assess the impact of these events on hospitalization and mortality.</p>
<p><strong>Methods:</strong> A distributed network cohort using primary care records from Netherlands, Italy, Spain and the UK; and outpatient specialist records from Germany. The Spanish database was linked to hospital admissions. Participants were followed from a diagnosis of COVID-19 or positive RT-PCR test on or after 1st September 2020. Outcomes included VTE, ATE, hospitalization, and mortality up to 90-days after index date. We estimated cumulative incidences for the study outcomes. Multi-state models were used to study the association between VTE/ATE occurrence and hospitalization and mortality.</p>
<p><strong>Results:</strong> Overall, 909,473 COVID-19 cases and 32,329 patients hospitalised with COVID-19 were studied. Cumulative 90-day incidence of VTE ranged from 0.2% to 0.8%, and up to 4.5% for those hospitalised. For ATE, estimates ranged from 0.1% to 0.8%, increasing to 3.1% among those hospitalised. Mortality ranged between 1.1% and 2.0%, rising to 14.6% for hospitalised patients. VTE and ATE were associated with worse outcomes. For example, VTE and ATE whilst outpatient resulted in adjusted HR for death of 4.42 [3.07-6.36] and 3.16 [2.65-3.75] respectively.</p>
<p><strong>Conclusions and Relevance:</strong> Risks of VTE and ATE were up to one percent among COVID-19 cases, but increase with age, among males, and for those hospitalized. Their occurrence is associated with excess mortality, underling the importance of effective treatment strategies that reduce their frequency.</p> |
| first_indexed | 2024-03-07T07:49:30Z |
| format | Journal article |
| id | oxford-uuid:1b1b7887-d0f3-4e78-8a31-f0676ecaa7f7 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T07:49:30Z |
| publishDate | 2022 |
| publisher | Elsevier |
| record_format | dspace |
| spelling | oxford-uuid:1b1b7887-d0f3-4e78-8a31-f0676ecaa7f72023-07-10T15:17:29ZVenous or arterial thrombosis and mortality among COVID-19 cases: a European network cohort studyJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:1b1b7887-d0f3-4e78-8a31-f0676ecaa7f7EnglishSymplectic ElementsElsevier2022Burn, EDuarte-Salles, TFernandez-Bertolin, SReyes, CKostka, KDelmestri, ARijnbeek, PVerhamme, KPrieto-Alhambra, D<p><strong>Background:</strong> There are limited data on the incidence of thrombosis among COVID-19 cases, with most research concentrated on hospitalised patients. We estimated the incidence of venous thromboembolism (VTE), arterial thromboembolism (ATE), and death among COVID-19 cases; and to assess the impact of these events on hospitalization and mortality.</p> <p><strong>Methods:</strong> A distributed network cohort using primary care records from Netherlands, Italy, Spain and the UK; and outpatient specialist records from Germany. The Spanish database was linked to hospital admissions. Participants were followed from a diagnosis of COVID-19 or positive RT-PCR test on or after 1st September 2020. Outcomes included VTE, ATE, hospitalization, and mortality up to 90-days after index date. We estimated cumulative incidences for the study outcomes. Multi-state models were used to study the association between VTE/ATE occurrence and hospitalization and mortality.</p> <p><strong>Results:</strong> Overall, 909,473 COVID-19 cases and 32,329 patients hospitalised with COVID-19 were studied. Cumulative 90-day incidence of VTE ranged from 0.2% to 0.8%, and up to 4.5% for those hospitalised. For ATE, estimates ranged from 0.1% to 0.8%, increasing to 3.1% among those hospitalised. Mortality ranged between 1.1% and 2.0%, rising to 14.6% for hospitalised patients. VTE and ATE were associated with worse outcomes. For example, VTE and ATE whilst outpatient resulted in adjusted HR for death of 4.42 [3.07-6.36] and 3.16 [2.65-3.75] respectively.</p> <p><strong>Conclusions and Relevance:</strong> Risks of VTE and ATE were up to one percent among COVID-19 cases, but increase with age, among males, and for those hospitalized. Their occurrence is associated with excess mortality, underling the importance of effective treatment strategies that reduce their frequency.</p> |
| spellingShingle | Burn, E Duarte-Salles, T Fernandez-Bertolin, S Reyes, C Kostka, K Delmestri, A Rijnbeek, P Verhamme, K Prieto-Alhambra, D Venous or arterial thrombosis and mortality among COVID-19 cases: a European network cohort study |
| title | Venous or arterial thrombosis and mortality among COVID-19 cases: a European network cohort study |
| title_full | Venous or arterial thrombosis and mortality among COVID-19 cases: a European network cohort study |
| title_fullStr | Venous or arterial thrombosis and mortality among COVID-19 cases: a European network cohort study |
| title_full_unstemmed | Venous or arterial thrombosis and mortality among COVID-19 cases: a European network cohort study |
| title_short | Venous or arterial thrombosis and mortality among COVID-19 cases: a European network cohort study |
| title_sort | venous or arterial thrombosis and mortality among covid 19 cases a european network cohort study |
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