Incidence of Venous Thromboembolism and Mortality in Patients with Initial Presentation of COVID-19
Venous thromboembolism (VTE) has emerged as an important issue in patients with COVID-19. The purpose of this study is to identify the incidence of VTE and mortality in COVID-19 patients initially presenting to a large health system. Our retrospective study included adult patients (excluding patient...
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| Veröffentlicht in: | Journal of thrombosis and thrombolysis 2021-05, Vol.51 (4), p.897-901 |
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| creator | Giannis, Dimitrios Barish, Matthew A. Goldin, Mark Cohen, Stuart L. Kohn, Nina Gianos, Eugenia Chatterjee, Saurav Lesser, Martin Coppa, Kevin Hirsch, Jamie S. McGinn, Thomas Spyropoulos, Alex C. |
| description | Venous thromboembolism (VTE) has emerged as an important issue in patients with COVID-19. The purpose of this study is to identify the incidence of VTE and mortality in COVID-19 patients initially presenting to a large health system. Our retrospective study included adult patients (excluding patients presenting with obstetric/gynecologic conditions) across a multihospital health system in the New York Metropolitan Region from March 1-April 27, 2020. VTE and mortality rates within 8 h of assessment were described. In 10,871 adults with COVID-19, 118 patients (1.09%) were diagnosed with symptomatic VTE (101 pulmonary embolism, 17 deep vein thrombosis events) and 28 patients (0.26%) died during initial assessment. Among these 146 patients, 64.4% were males, 56.8% were 60 years or older, 15.1% had a BMI > 35, and 11.6% were admitted to the intensive care unit. Comorbidities included hypertension (46.6%), diabetes (24.7%), hyperlipidemia (14.4%), chronic lung disease (12.3%), coronary artery disease (11.0%), and prior VTE (7.5%). Key medications included corticosteroids (22.6%), statins (21.2%), antiplatelets (20.6%), and anticoagulants (20.6%). Highest D-Dimer was greater than six times the upper limit of normal in 51.4%. Statin and antiplatelet use were associated with decreased VTE or mortality (each p |
| doi_str_mv | 10.1007/s11239-021-02413-7 |
| format | Article |
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The purpose of this study is to identify the incidence of VTE and mortality in COVID-19 patients initially presenting to a large health system. Our retrospective study included adult patients (excluding patients presenting with obstetric/gynecologic conditions) across a multihospital health system in the New York Metropolitan Region from March 1-April 27, 2020. VTE and mortality rates within 8 h of assessment were described. In 10,871 adults with COVID-19, 118 patients (1.09%) were diagnosed with symptomatic VTE (101 pulmonary embolism, 17 deep vein thrombosis events) and 28 patients (0.26%) died during initial assessment. Among these 146 patients, 64.4% were males, 56.8% were 60 years or older, 15.1% had a BMI > 35, and 11.6% were admitted to the intensive care unit. Comorbidities included hypertension (46.6%), diabetes (24.7%), hyperlipidemia (14.4%), chronic lung disease (12.3%), coronary artery disease (11.0%), and prior VTE (7.5%). Key medications included corticosteroids (22.6%), statins (21.2%), antiplatelets (20.6%), and anticoagulants (20.6%). Highest D-Dimer was greater than six times the upper limit of normal in 51.4%. Statin and antiplatelet use were associated with decreased VTE or mortality (each p < 0.01). In COVID-19 patients who initially presented to a large multihospital health system, the overall symptomatic VTE and mortality rate was over 1.0%. Statin and antiplatelet use were associated with decreased VTE or mortality. The potential benefits of antithrombotics in high risk COVID-19 patients during the pre-hospitalization period deserves study.</description><identifier>ISSN: 0929-5305</identifier><identifier>EISSN: 1573-742X</identifier><identifier>DOI: 10.1007/s11239-021-02413-7</identifier><identifier>PMID: 33665766</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Anticoagulants ; Cardiology ; Cardiovascular disease ; Coronary artery ; Coronaviruses ; Corticosteroids ; COVID-19 ; COVID-19 - complications ; COVID-19 - epidemiology ; COVID-19 - physiopathology ; COVID-19 - therapy ; Diabetes mellitus ; Embolism ; Female ; Fibrin Fibrinogen Degradation Products - analysis ; Heart diseases ; Hematology ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use ; Hyperlipidemia ; Incidence ; Intensive Care Units - statistics & numerical data ; Lung diseases ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Mortality ; New York - epidemiology ; Outcome and Process Assessment, Health Care ; Platelet Aggregation Inhibitors - therapeutic use ; Protective Factors ; Pulmonary Embolism - blood ; Pulmonary Embolism - diagnosis ; Pulmonary Embolism - etiology ; Pulmonary Embolism - mortality ; Retrospective Studies ; Risk Factors ; SARS-CoV-2 - isolation & purification ; Statins ; Thromboembolism ; Thrombosis ; Venous Thrombosis - blood ; Venous Thrombosis - diagnosis ; Venous Thrombosis - etiology ; Venous Thrombosis - mortality</subject><ispartof>Journal of thrombosis and thrombolysis, 2021-05, Vol.51 (4), p.897-901</ispartof><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC part of Springer Nature 2021</rights><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC part of Springer Nature 2021.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-5a52a76e6184ff6da0b245becb009dd499008f6364c843bd7ebf2b5ab93ab1c63</citedby><cites>FETCH-LOGICAL-c474t-5a52a76e6184ff6da0b245becb009dd499008f6364c843bd7ebf2b5ab93ab1c63</cites><orcidid>0000-0001-9246-976X ; 0000-0002-3175-461X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11239-021-02413-7$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11239-021-02413-7$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,777,781,882,27905,27906,41469,42538,51300</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33665766$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Giannis, Dimitrios</creatorcontrib><creatorcontrib>Barish, Matthew A.</creatorcontrib><creatorcontrib>Goldin, Mark</creatorcontrib><creatorcontrib>Cohen, Stuart L.</creatorcontrib><creatorcontrib>Kohn, Nina</creatorcontrib><creatorcontrib>Gianos, Eugenia</creatorcontrib><creatorcontrib>Chatterjee, Saurav</creatorcontrib><creatorcontrib>Lesser, Martin</creatorcontrib><creatorcontrib>Coppa, Kevin</creatorcontrib><creatorcontrib>Hirsch, Jamie S.</creatorcontrib><creatorcontrib>McGinn, Thomas</creatorcontrib><creatorcontrib>Spyropoulos, Alex C.</creatorcontrib><creatorcontrib>COVID-19 Consortium Group</creatorcontrib><creatorcontrib>the COVID-19 Consortium Group</creatorcontrib><title>Incidence of Venous Thromboembolism and Mortality in Patients with Initial Presentation of COVID-19</title><title>Journal of thrombosis and thrombolysis</title><addtitle>J Thromb Thrombolysis</addtitle><addtitle>J Thromb Thrombolysis</addtitle><description>Venous thromboembolism (VTE) has emerged as an important issue in patients with COVID-19. The purpose of this study is to identify the incidence of VTE and mortality in COVID-19 patients initially presenting to a large health system. Our retrospective study included adult patients (excluding patients presenting with obstetric/gynecologic conditions) across a multihospital health system in the New York Metropolitan Region from March 1-April 27, 2020. VTE and mortality rates within 8 h of assessment were described. In 10,871 adults with COVID-19, 118 patients (1.09%) were diagnosed with symptomatic VTE (101 pulmonary embolism, 17 deep vein thrombosis events) and 28 patients (0.26%) died during initial assessment. Among these 146 patients, 64.4% were males, 56.8% were 60 years or older, 15.1% had a BMI > 35, and 11.6% were admitted to the intensive care unit. Comorbidities included hypertension (46.6%), diabetes (24.7%), hyperlipidemia (14.4%), chronic lung disease (12.3%), coronary artery disease (11.0%), and prior VTE (7.5%). Key medications included corticosteroids (22.6%), statins (21.2%), antiplatelets (20.6%), and anticoagulants (20.6%). Highest D-Dimer was greater than six times the upper limit of normal in 51.4%. Statin and antiplatelet use were associated with decreased VTE or mortality (each p < 0.01). In COVID-19 patients who initially presented to a large multihospital health system, the overall symptomatic VTE and mortality rate was over 1.0%. Statin and antiplatelet use were associated with decreased VTE or mortality. The potential benefits of antithrombotics in high risk COVID-19 patients during the pre-hospitalization period deserves study.</description><subject>Anticoagulants</subject><subject>Cardiology</subject><subject>Cardiovascular disease</subject><subject>Coronary artery</subject><subject>Coronaviruses</subject><subject>Corticosteroids</subject><subject>COVID-19</subject><subject>COVID-19 - complications</subject><subject>COVID-19 - epidemiology</subject><subject>COVID-19 - physiopathology</subject><subject>COVID-19 - therapy</subject><subject>Diabetes mellitus</subject><subject>Embolism</subject><subject>Female</subject><subject>Fibrin Fibrinogen Degradation Products - analysis</subject><subject>Heart diseases</subject><subject>Hematology</subject><subject>Humans</subject><subject>Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use</subject><subject>Hyperlipidemia</subject><subject>Incidence</subject><subject>Intensive Care Units - statistics & numerical data</subject><subject>Lung diseases</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>New York - epidemiology</subject><subject>Outcome and Process Assessment, Health Care</subject><subject>Platelet Aggregation Inhibitors - therapeutic use</subject><subject>Protective Factors</subject><subject>Pulmonary Embolism - blood</subject><subject>Pulmonary Embolism - diagnosis</subject><subject>Pulmonary Embolism - etiology</subject><subject>Pulmonary Embolism - mortality</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>SARS-CoV-2 - isolation & purification</subject><subject>Statins</subject><subject>Thromboembolism</subject><subject>Thrombosis</subject><subject>Venous Thrombosis - blood</subject><subject>Venous Thrombosis - diagnosis</subject><subject>Venous Thrombosis - etiology</subject><subject>Venous Thrombosis - mortality</subject><issn>0929-5305</issn><issn>1573-742X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9UU1PXCEUJU2NjtY_0EVD0k03r_LNsDEx06qTaHShxh0BHs_BvAcKbzT--zKO1eqiixsI59xzz-UA8BWjnxghuVcwJlQ1iOBaDNNGfgITzGW9MHL9GUyQIqrhFPEtsF3KLUJIKUQ2wRalQnApxAS4eXSh9dF5mDp45WNaFnixyGmwydfqQxmgiS08TXk0fRifYIjw3IzBx7HAxzAu4DyGMZgenmdf6mvFUlypzc6u5r8arL6Ajc70xe--nDvg8vD3xey4OTk7ms8OThrHJBsbbjgxUniBp6zrRGuQJYxb72z13basekfTTlDB3JRR20pvO2K5sYoai52gO2B_rXu3tINvXfWSTa_vchhMftLJBP0eiWGhb9KDlooSKUgV-PEikNP90pdRD6E43_cm-vovmjA15VggxCv1-wfqbVrmWNfThGPFhUJ45YisWS6nUrLvXs1gpFcZ6nWGumaonzPUsjZ9-3eN15a_oVUCXRNKheKNz2-z_yP7BxvFqEI</recordid><startdate>20210501</startdate><enddate>20210501</enddate><creator>Giannis, Dimitrios</creator><creator>Barish, Matthew A.</creator><creator>Goldin, Mark</creator><creator>Cohen, Stuart L.</creator><creator>Kohn, Nina</creator><creator>Gianos, Eugenia</creator><creator>Chatterjee, Saurav</creator><creator>Lesser, Martin</creator><creator>Coppa, Kevin</creator><creator>Hirsch, Jamie S.</creator><creator>McGinn, Thomas</creator><creator>Spyropoulos, Alex C.</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-9246-976X</orcidid><orcidid>https://orcid.org/0000-0002-3175-461X</orcidid></search><sort><creationdate>20210501</creationdate><title>Incidence of Venous Thromboembolism and Mortality in Patients with Initial Presentation of COVID-19</title><author>Giannis, Dimitrios ; Barish, Matthew A. ; Goldin, Mark ; Cohen, Stuart L. ; Kohn, Nina ; Gianos, Eugenia ; Chatterjee, Saurav ; Lesser, Martin ; Coppa, Kevin ; Hirsch, Jamie S. ; McGinn, Thomas ; Spyropoulos, Alex C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-5a52a76e6184ff6da0b245becb009dd499008f6364c843bd7ebf2b5ab93ab1c63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Anticoagulants</topic><topic>Cardiology</topic><topic>Cardiovascular disease</topic><topic>Coronary artery</topic><topic>Coronaviruses</topic><topic>Corticosteroids</topic><topic>COVID-19</topic><topic>COVID-19 - complications</topic><topic>COVID-19 - epidemiology</topic><topic>COVID-19 - physiopathology</topic><topic>COVID-19 - therapy</topic><topic>Diabetes mellitus</topic><topic>Embolism</topic><topic>Female</topic><topic>Fibrin Fibrinogen Degradation Products - analysis</topic><topic>Heart diseases</topic><topic>Hematology</topic><topic>Humans</topic><topic>Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use</topic><topic>Hyperlipidemia</topic><topic>Incidence</topic><topic>Intensive Care Units - statistics & numerical data</topic><topic>Lung diseases</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>New York - epidemiology</topic><topic>Outcome and Process Assessment, Health Care</topic><topic>Platelet Aggregation Inhibitors - therapeutic use</topic><topic>Protective Factors</topic><topic>Pulmonary Embolism - blood</topic><topic>Pulmonary Embolism - diagnosis</topic><topic>Pulmonary Embolism - etiology</topic><topic>Pulmonary Embolism - mortality</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>SARS-CoV-2 - isolation & purification</topic><topic>Statins</topic><topic>Thromboembolism</topic><topic>Thrombosis</topic><topic>Venous Thrombosis - blood</topic><topic>Venous Thrombosis - diagnosis</topic><topic>Venous Thrombosis - etiology</topic><topic>Venous Thrombosis - mortality</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Giannis, Dimitrios</creatorcontrib><creatorcontrib>Barish, Matthew A.</creatorcontrib><creatorcontrib>Goldin, Mark</creatorcontrib><creatorcontrib>Cohen, Stuart L.</creatorcontrib><creatorcontrib>Kohn, Nina</creatorcontrib><creatorcontrib>Gianos, Eugenia</creatorcontrib><creatorcontrib>Chatterjee, Saurav</creatorcontrib><creatorcontrib>Lesser, Martin</creatorcontrib><creatorcontrib>Coppa, Kevin</creatorcontrib><creatorcontrib>Hirsch, Jamie S.</creatorcontrib><creatorcontrib>McGinn, Thomas</creatorcontrib><creatorcontrib>Spyropoulos, Alex C.</creatorcontrib><creatorcontrib>COVID-19 Consortium Group</creatorcontrib><creatorcontrib>the COVID-19 Consortium Group</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health and Medical</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of thrombosis and thrombolysis</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Giannis, Dimitrios</au><au>Barish, Matthew A.</au><au>Goldin, Mark</au><au>Cohen, Stuart L.</au><au>Kohn, Nina</au><au>Gianos, Eugenia</au><au>Chatterjee, Saurav</au><au>Lesser, Martin</au><au>Coppa, Kevin</au><au>Hirsch, Jamie S.</au><au>McGinn, Thomas</au><au>Spyropoulos, Alex C.</au><aucorp>COVID-19 Consortium Group</aucorp><aucorp>the COVID-19 Consortium Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Incidence of Venous Thromboembolism and Mortality in Patients with Initial Presentation of COVID-19</atitle><jtitle>Journal of thrombosis and thrombolysis</jtitle><stitle>J Thromb Thrombolysis</stitle><addtitle>J Thromb Thrombolysis</addtitle><date>2021-05-01</date><risdate>2021</risdate><volume>51</volume><issue>4</issue><spage>897</spage><epage>901</epage><pages>897-901</pages><issn>0929-5305</issn><eissn>1573-742X</eissn><abstract>Venous thromboembolism (VTE) has emerged as an important issue in patients with COVID-19. The purpose of this study is to identify the incidence of VTE and mortality in COVID-19 patients initially presenting to a large health system. Our retrospective study included adult patients (excluding patients presenting with obstetric/gynecologic conditions) across a multihospital health system in the New York Metropolitan Region from March 1-April 27, 2020. VTE and mortality rates within 8 h of assessment were described. In 10,871 adults with COVID-19, 118 patients (1.09%) were diagnosed with symptomatic VTE (101 pulmonary embolism, 17 deep vein thrombosis events) and 28 patients (0.26%) died during initial assessment. Among these 146 patients, 64.4% were males, 56.8% were 60 years or older, 15.1% had a BMI > 35, and 11.6% were admitted to the intensive care unit. Comorbidities included hypertension (46.6%), diabetes (24.7%), hyperlipidemia (14.4%), chronic lung disease (12.3%), coronary artery disease (11.0%), and prior VTE (7.5%). Key medications included corticosteroids (22.6%), statins (21.2%), antiplatelets (20.6%), and anticoagulants (20.6%). Highest D-Dimer was greater than six times the upper limit of normal in 51.4%. Statin and antiplatelet use were associated with decreased VTE or mortality (each p < 0.01). In COVID-19 patients who initially presented to a large multihospital health system, the overall symptomatic VTE and mortality rate was over 1.0%. Statin and antiplatelet use were associated with decreased VTE or mortality. The potential benefits of antithrombotics in high risk COVID-19 patients during the pre-hospitalization period deserves study.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>33665766</pmid><doi>10.1007/s11239-021-02413-7</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0001-9246-976X</orcidid><orcidid>https://orcid.org/0000-0002-3175-461X</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of thrombosis and thrombolysis, 2021-05, Vol.51 (4), p.897-901 |
| issn | 0929-5305 1573-742X |
| language | eng |
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| source | MEDLINE; Springer journals |
| subjects | Anticoagulants Cardiology Cardiovascular disease Coronary artery Coronaviruses Corticosteroids COVID-19 COVID-19 - complications COVID-19 - epidemiology COVID-19 - physiopathology COVID-19 - therapy Diabetes mellitus Embolism Female Fibrin Fibrinogen Degradation Products - analysis Heart diseases Hematology Humans Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use Hyperlipidemia Incidence Intensive Care Units - statistics & numerical data Lung diseases Male Medicine Medicine & Public Health Middle Aged Mortality New York - epidemiology Outcome and Process Assessment, Health Care Platelet Aggregation Inhibitors - therapeutic use Protective Factors Pulmonary Embolism - blood Pulmonary Embolism - diagnosis Pulmonary Embolism - etiology Pulmonary Embolism - mortality Retrospective Studies Risk Factors SARS-CoV-2 - isolation & purification Statins Thromboembolism Thrombosis Venous Thrombosis - blood Venous Thrombosis - diagnosis Venous Thrombosis - etiology Venous Thrombosis - mortality |
| title | Incidence of Venous Thromboembolism and Mortality in Patients with Initial Presentation of COVID-19 |
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