Association Between the Development of Thrombosis and Worsening of Disease Severity in Patients With Moderate COVID-19 on Admission　― From the CLOT-COVID Study ―

Abstract

Background:The worsening of coronavirus disease 2019 (COVID-19) severity is a critical issue in current clinical settings and may be associated with the development of thrombosis. Methods and Results:This study used patient data obtained in the CLOT-COVID study, a retrospective multicenter cohort study. The demographics of patients with moderate COVID-19 on admission with and without worsened severity during hospitalization were compared and predictors were identified. Of 927 patients with moderate COVID-19 on admission, 182 (19.6%) had worsened severity during hospitalization. Patients with worsening of severity were older, more likely to have hypertension, diabetes, heart disease, and active cancer, and more likely to use pharmacological thromboprophylaxis. Patients with worsening of severity had higher D-dimer levels on admission and were more likely to develop thrombosis and major bleeding during hospitalization than those without worsening. Increased age (odds ratio [OR]: 1.02, 95% confidence interval [

Mortality-associated Risk Factors in Hospitalized COVID-19 Patients in Japan: Findings of the CLOT-COVID Study

“…This physician-initiated, observational cohort study involved the analysis of data accumulated in the nationwide “The Thrombosis and Anticoagulation Therapy in patients with COVID-19 in Japan Study” (CLOT-COVID Study; UMIN000045800), which enrolled consecutive hospitalized COVID-19 patients from April to September 2021 in 16 centers in Japan. 18 – 22 The primary objective of the CLOT-COVID study was to reveal the current status of thrombosis and anticoagulation therapy in patients with COVID-19 in Japan. 18 Patients with COVID-19 confirmed by polymerase chain reaction were eligible for inclusion.…”

Thrombosis and Anticoagulation Strategies in Patients with COVID-19 Including Japanese Perspective

“…To elucidate the detailed status of thrombosis, including VTE, in Japan, a multicenter retrospective cohort study was conducted to investigate the incidence and clinical features of VTE among hospitalized COVID-19 patients who underwent contrast-enhanced computed tomography (CECT) during hospitalization at 22 The optimal intensity of anticoagulation therapy for COVID-19 according to its severity might also be a big issue in Japan, although it has been investigated in a number of previous clinical trials, mainly in the Caucasian population. As for the anticoagulation therapy for moderately ill patients with COVID-19, a previous study showed that approximately 20% of patients with moderate COVID-19 experienced worsened severity during hospitalization with which increased age, diabetes, D-dimer levels ＞1.0 µg/mL on admission, and the development of thrombosis during hospitalization were significantly associated 63) . These results indicated that a more aggressive pharmacological thromboprophylaxis might be helpful for the prevention of worsening COVID-19 severity among high-risk patients.…”

Clinical Features Comparing Arterial Thrombosis and Venous Thromboembolism in Hospitalized Patients with COVID-19: Result from the CLOT-COVID Study

“… 9 ) Thrombus development was associated with COVID-19 severity, and bleeding risk was related to COVID-19 severity and anticoagulation but not with age. 10 – 12 )…”

“…9) Thrombus development was associated with COVID-19 severity, and bleeding risk was related to COVID-19 severity and anticoagulation but not with age. [10][11][12] In patients with COVID-19, VTE, particularly pulmonary embolism (PE), may be a major cause of thrombosis. [13][14][15] However, there has been limited data on the detailed types of thrombosis, which could be important for understanding thrombosis associated with COVID-19.…”