Abstract
Background: Complications under anticoagulant treatment in patients with COVID-19-associated venous thromboembolism (VTE) have not been consistently reported. Objectives: This study aimed to compare the 90-day rates of VTE recurrences and major bleeding in patients with COVID-19-associated VTE versus those with VTE without COVID-19. Methods: We used the RIETE registry to compare the 3-month outcomes in patients with COVID-19-associated VTE versus those with VTE without COVID-19. Results: The study included 1,747 patients with COVID-19-associated VTE and 8,711 with VTE without COVID-19. Patients with COVID-19-associated VTE were more likely to be hospitalized at baseline and to present with pulmonary embolism. During the first 90 days, 123 patients (1.17%) developed VTE recurrences, and 266 (2.54%) experienced major bleeding. Patients with COVID-19-associated VTE had a similar rate of VTE recurrences (0.9% vs 1.2%) but a higher rate of major bleeding (4.6% vs 2.1%; P <.001) than those without COVID-19. Multivariable analysis adjusted for competing risks showed that patients with COVID-19-associated VTE had an increased risk of major bleeding (subhazard ratio, 1.395; 95% confidence interval, 1.037-1.877). The 30-day mortality after major bleeding was 26.3% in patients with COVID-19-associated VTE and 17.7% in those without COVID-19. Conclusion: Patients with COVID-19-associated VTE had a 5-fold higher rate of major bleeding than VTE recurrences during the first 90 days of anticoagulation. In VTE patients without COVID-19, both rates were similar. These findings highlight the importance of carefully monitoring and optimizing anticoagulation in these patients.
Original language | English |
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Article number | 102206 |
Journal | Research and Practice in Thrombosis and Haemostasis |
Volume | 7 |
Issue number | 7 |
DOIs | |
State | Published - Oct 2023 |
Bibliographical note
Publisher Copyright:© 2023 The Author(s)
Funding
We express our gratitude to Sanofi Spain and ROVI for supporting this Registry with an unrestricted educational grant. We also thank the RIETE Registry Coordinating Center, S&H Medical Science Service, for their quality control data, logistic and administrative support. P.D.R. R.A.B, L.J.P. F.G.V. and M.M. conceptualized the study. P.D.R. R.A.B, L.J.P. and M.M. provided the methodology. P.D.R. R.A.B, L.J.P. and M.M validated the study. P.D.R. R.A.B, L.J.P. F.G.V. A.B.R. A.V. I.F. G.V. A.L.R. M.M. and the RIETE Investigators investigated the study; P.D.R. R.A.B, and M.M. curated the data. P.D.R. R.A.B, L.J.P. and M.M. prepared the original draft. P.D.R. R.A.B, L.J.P. F.G.V. A.B.R. A.V. I.F. G.V. A.L.R. M.M. and the RIETE Investigators reviewed and edited the manuscript. M.M. supervised the study. M.M. administered the project. All authors have read and agreed to the published version of the manuscript. The study was supported by Sanofi Spain and ROVI with an unrestricted educational grant. The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and the decision to submit the manuscript for publication. There are no competing interests to disclose.
Funders | Funder number |
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S&H Medical Science Service |
Keywords
- COVID-19
- anticoagulants
- hemorrhage
- pulmonary embolism
- venous thromboembolism