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10.1182/blood.2020010529

http://scihub22266oqcxt.onion/10.1182/blood.2020010529
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33824972!8032474!33824972
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suck abstract from ncbi


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pmid33824972      Blood 2021 ; 137 (20): 2838-2847
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  • Postdischarge thromboembolic outcomes and mortality of hospitalized patients with COVID-19: the CORE-19 registry #MMPMID33824972
  • Giannis D; Allen SL; Tsang J; Flint S; Pinhasov T; Williams S; Tan G; Thakur R; Leung C; Snyder M; Bhatia C; Garrett D; Cotte C; Isaacs S; Gugerty E; Davidson A; Marder GS; Schnitzer A; Goldberg B; McGinn T; Davidson KW; Barish MA; Qiu M; Zhang M; Goldin M; Matsagkas M; Arnaoutoglou E; Spyropoulos AC
  • Blood 2021[May]; 137 (20): 2838-2847 PMID33824972show ga
  • Thromboembolic events, including venous thromboembolism (VTE) and arterial thromboembolism (ATE), and mortality from subclinical thrombotic events occur frequently in coronavirus disease 2019 (COVID-19) inpatients. Whether the risk extends postdischarge has been controversial. Our prospective registry included consecutive patients with COVID-19 hospitalized within our multihospital system from 1 March to 31 May 2020. We captured demographics, comorbidities, laboratory parameters, medications, postdischarge thromboprophylaxis, and 90-day outcomes. Data from electronic health records, health informatics exchange, radiology database, and telephonic follow-up were merged. Primary outcome was a composite of adjudicated VTE, ATE, and all-cause mortality (ACM). Principal safety outcome was major bleeding (MB). Among 4906 patients (53.7% male), mean age was 61.7 years. Comorbidities included hypertension (38.6%), diabetes (25.1%), obesity (18.9%), and cancer history (13.1%). Postdischarge thromboprophylaxis was prescribed in 13.2%. VTE rate was 1.55%; ATE, 1.71%; AlphaCM, 4.83%; and MB, 1.73%. Composite primary outcome rate was 7.13% and significantly associated with advanced age (odds ratio [OR], 3.66; 95% CI, 2.84-4.71), prior VTE (OR, 2.99; 95% CI, 2.00-4.47), intensive care unit (ICU) stay (OR, 2.22; 95% CI, 1.78-2.93), chronic kidney disease (CKD; OR, 2.10; 95% CI, 1.47-3.0), peripheral arterial disease (OR, 2.04; 95% CI, 1.10-3.80), carotid occlusive disease (OR, 2.02; 95% CI, 1.30-3.14), IMPROVE-DD VTE score >/=4 (OR, 1.51; 95% CI, 1.06-2.14), and coronary artery disease (OR, 1.50; 95% CI, 1.04-2.17). Postdischarge anticoagulation was significantly associated with reduction in primary outcome (OR, 0.54; 95% CI, 0.47-0.81). Postdischarge VTE, ATE, and ACM occurred frequently after COVID-19 hospitalization. Advanced age, cardiovascular risk factors, CKD, IMPROVE-DD VTE score >/=4, and ICU stay increased risk. Postdischarge anticoagulation reduced risk by 46%.
  • |Aged[MESH]
  • |Anticoagulants/therapeutic use[MESH]
  • |COVID-19/*complications[MESH]
  • |Female[MESH]
  • |Humans[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |Patient Discharge[MESH]
  • |Registries[MESH]
  • |Risk Factors[MESH]
  • |SARS-CoV-2[MESH]


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