Incidence of Venous Thromboembolism and Mortality in Patients with Initial Presentation of COVID-19

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.

doi:10.1007/s11239-021-02413-7

Cited by 41 publications

(46 citation statements)

References 13 publications

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“…A multihospital retrospective study revealed that antiplatelet and statin use decreased VTE or mortality by 35% and 45%, respectively in patients with COVID-19. 10 Another study also showed that patients with COVID-19 receiving therapeutic anticoagulation prior to admission had three times less risk of developing VTEs and did not significantly suffer more from all-cause death than patients without anticoagulation. 8 Furthermore, heparin use during admission was associated with two times as less mortality in patients with HF with COVID-19.…”

Section: Discussionmentioning

confidence: 97%

Vascular comorbidities worsen prognosis of patients with heart failure hospitalised with COVID-19

et al. 2021

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BackgroundPrior diagnosis of heart failure (HF) is associated with increased length of hospital stay (LOS) and mortality from COVID-19. Associations between substance use, venous thromboembolism (VTE) or peripheral arterial disease (PAD) and its effects on LOS or mortality in patients with HF hospitalised with COVID-19 remain unknown.ObjectiveThis study identified risk factors associated with poor in-hospital outcomes among patients with HF hospitalised with COVID-19.MethodsCase–control study was conducted of patients with prior diagnosis of HF hospitalised with COVID-19 at an academic tertiary care centre from 1 January 2020 to 28 February 2021. Patients with HF hospitalised with COVID-19 with risk factors were compared with those without risk factors for clinical characteristics, LOS and mortality. Multivariate regression was conducted to identify multiple predictors of increased LOS and in-hospital mortality in patients with HF hospitalised with COVID-19.ResultsTotal of 211 patients with HF were hospitalised with COVID-19. Women had longer LOS than men (9 days vs 7 days; p<0.001). Compared with patients without PAD or ischaemic stroke, patients with PAD or ischaemic stroke had longer LOS (7 days vs 9 days; p=0.012 and 7 days vs 11 days, p<0.001, respectively). Older patients (aged 65 and above) had increased in-hospital mortality compared with younger patients (adjusted OR: 1.04; 95% CI 1.00 to 1.07; p=0.036). Prior diagnosis of VTE increased mortality more than threefold in patients with HF hospitalised with COVID-19 (adjusted OR: 3.33; 95% CI 1.29 to 8.43; p=0.011).ConclusionVascular diseases increase LOS and mortality in patients with HF hospitalised with COVID-19.

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Section: Discussionmentioning

confidence: 97%

Vascular comorbidities worsen prognosis of patients with heart failure hospitalised with COVID-19

et al. 2021

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“…In patients with active COVID-19 infections undergoing surgery, there is a reported increase in surgical mortality and complications, 13 specifically increased pulmonary complications 14 and venous thromboembolism. 15,16 However, current data remains mixed with some showing no change in the rate of post-operative morbidity and mortality 17,18 In one large international multicenter cohort of 1128 patients undergoing surgery at 235 hospitals in 24 countries from January 1 to March 21, 2020, the COVID-19 infection rate was 26.1% preoperatively, with 51.2% suffering post-operative pulmonary complications and over-all 30-day mortality at 23.8%. 14 In another multicenter international prospective cohort study of 140,231 surgical patients from 116 countries, 2.2% had a pre-operative COVID-19 positive test and the adjusted odds ratio for 30-day mortality was significantly higher in patients having surgery within 7 weeks of a COVID-19 infection.…”

Section: Discussionmentioning

confidence: 99%

Surgical Outcomes in Benign Gynecologic Surgery Patients during the COVID-19 Pandemic (SOCOVID study)

Kho

Chang

Hare

et al. 2022

Journal of Minimally Invasive Gynecology

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Study Objective To determine the incidence of perioperative COVID-19 in women undergoing benign gynecologic surgery, and to evaluate perioperative complication rates in patients with active, prior or no prior SARS-CoV-2 infection. Design Multicenter prospective cohort study Setting Ten institutions in the United States Patients Patients over the age of 18 years who underwent benign gynecologic surgery from July 1, 2020 to December 31, 2020 were included. All patients were followed from the time of surgery until 10 weeks post-operatively. Those with intra-uterine pregnancy or known gynecologic malignancy were excluded. Interventions Benign gynecologic surgery Measurements The primary outcome was the incidence of perioperative COVID-19 infections which was stratified as 1) prior COVID-19 infection, 2) pre-operative COVID-19 infection and 3) post-operative COVID-19 infection. Secondary outcomes included adverse events and mortality following surgery, as well as predictors for post-operative COVID-19 infection. If surgery was delayed due to the COVID-19 pandemic, the reason for postponement and any subsequent adverse event was recorded. Main Results Of 3423 patients included for final analysis, 189 (5.5%) postponed their gynecologic surgery during the pandemic. Forty-three patients (1.3% of total cases) were due to a history of COVID-19. The majority (182 [96.3%]) had no sequelae attributed to surgical postponement. Following hospital discharge to 10 weeks post-operatively, 39 (1.1%) patients became infected with SARS-CoV-2. The mean duration of time between hospital discharge and the follow-up positive COVID-19 test was 22.1 ± 12.3 days (range 4-50 days). Eleven (31.4% of post-operative COVID-19 infections, 0.3% of total cases) of the newly diagnosed COVID-19 infections occurred within 14 days of hospital discharge. On multivariable logistic regression, living in the Southwest (adjOR 6.8) and single-unit increase in age-adjusted Charlson co-morbidity index (adjOR 1.2) increased the odds of post-operative COVID-19 infection. Peri-operative complications were not significantly higher in patients with a history of prior positive COVID-19 compared to those without a history of COVID-19, though the mean duration of time between prior COVID-19 diagnosis and surgery was 97 days (14 weeks). Conclusion In this large multi-center prospective cohort study of benign gynecologic surgeries, only 1.1% of patients developed a post-operative COVID-19 infection, with 0.3% of infection in the immediate 14-days after surgery. The incidence of post-operative complications was not different in those with and without prior COVID-19 infections.

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“…Our study also showed HF patients admitted for COVID-19 had longer LOS with diagnosis of PAD or ischemic stroke (7 days vs. 9 days; p = 0.012 and 7 days vs. 11 days, p < 0.001; respectively). A multihospital retrospective study revealed that antiplatelet and statin use decreased VTE or mortality by 35% and 45%, respectively in COVID-19 patients, [11]. Another study also showed that COVID-19 patients receiving therapeutic anticoagulation prior to admission had three times less risk of developing VTEs and did not significantly suffer more from all-cause death than patients without anticoagulation 7 .…”

Section: Discussionmentioning

confidence: 99%

Vascular Comorbidities Worsen Prognosis of Patients with Heart Failure Hospitalized with COVID-19

Mok

Malpartida

O’Dell

et al. 2021

Preprint

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Background: Prior diagnosis of heart failure (HF) is associated with increased length of hospital stay (LOS) and mortality from Coronavirus disease-2019 (COVID-19). Associations between substance use, venous thromboembolism (VTE), or peripheral arterial disease (PAD) and its effects on LOS or mortality in patients with HF hospitalized with COVID-19 remains unknown. Objective: This study identified risk factors associated with poor in-hospital outcomes among patients with HF hospitalized with COVID-19. Methods: Case control study was conducted of patients with prior diagnosis of HF hospitalized with COVID-19 at an academic tertiary care center from January 1, 2020 to February 28, 2021. Patients with HF hospitalized with COVID-19 with risk factors were compared with those without risk factors for clinical characteristics, length of stay (LOS), and mortality. Multivariate regression was conducted to identify multiple predictors of increased LOS and in-hospital mortality in patients with HF hospitalized with COVID-19. Results: Total of 211 HF patients were hospitalized with COVID-19. Females had longer LOS than males (9 days vs. 7 days; p < 0.001). Compared with patients without peripheral arterial disease (PAD) or ischemic stroke, patients with PAD or ischemic stroke had longer LOS (7 days vs. 9 days; p = 0.012 and 7 days vs. 11 days, p < 0.001; respectively). Older patients (aged 65 and above) had increased in-hospital mortality compared to younger patients (Adjusted OR: 1.04; 95% CI: 1.00-1.07; p = 0.036). VTE increased mortality more than three-fold in patients with HF hospitalized with COVID-19 (Adjusted OR: 3.33; 95% CI: 1.29-8.43; p = 0.011). Conclusion: Vascular diseases increase LOS and mortality in patients with HF hospitalized with COVID-19.

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Incidence of Venous Thromboembolism and Mortality in Patients with Initial Presentation of COVID-19

Cited by 41 publications

References 13 publications

Vascular comorbidities worsen prognosis of patients with heart failure hospitalised with COVID-19

Vascular comorbidities worsen prognosis of patients with heart failure hospitalised with COVID-19

Surgical Outcomes in Benign Gynecologic Surgery Patients during the COVID-19 Pandemic (SOCOVID study)

Vascular Comorbidities Worsen Prognosis of Patients with Heart Failure Hospitalized with COVID-19

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