Dataset Information

Venous or arterial thrombosis in COVID-19 cases in the North Carolina COVID-19 Community Research Partnership (NC-CCRP).

ABSTRACT:

Background

Although the incidence of venous and arterial thrombosis after a COVID-19 diagnosis and hospitalization has been well described using data available from electronic health records (EHR), little is known about their incidence after mild infections.

Objectives

To characterize the cumulative incidence and risk factors for thrombosis after a COVID-19 diagnosis among those identified through the EHR and those with a self-reported case.

Methods

We calculated the cumulative incidence of thromboembolism diagnoses after EHR-identified and self-reported cases in the North Carolina COVID-19 Community Partnership, a prospective, multisite, longitudinal surveillance cohort using a Kaplan-Meier approach. We performed Cox regression to estimate the hazard of a thromboembolism diagnosis after COVID-19 by comorbidities, vaccination status, and dominant SARS-CoV-2 variant.

Results

Of a cohort of comprising more than 39,500 participants from 6 North Carolina sites, there were 6271 self-reported or EHR-diagnosed cases of COVID-19 reported between July 1, 2020, and April 30, 2022, of which 46 participants were diagnosed with a new-onset thromboembolism in the 365 days after their reported case. Self-reported cases had a lower estimated cumulative incidence of 0.15% (95% CI, 0.03-0.28) by day 90 and 0.64% (95% CI, 0.30-0.97) by day 365 compared with EHR-based diagnoses that had cumulative incidences of 0.73% (95% CI, 0.36-1.09) and 1.78 (95% CI, 1.14-2.46) by days 90 and 365 (log-rank test P value <.001). Those hospitalized and with pre-existing pulmonary and cardiovascular diseases were associated with the highest risk of a thromboembolism.

Conclusion

We observed a higher cumulative incidence of thromboembolism after EHR-identified COVID-19 than self-reported cases.

SUBMITTER: DeWitt ME

PROVIDER: S-EPMC9904855 | biostudies-literature | 2023 Feb

REPOSITORIES: biostudies-literature

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Publications

Venous or arterial thrombosis in COVID-19 cases in the North Carolina COVID-19 Community Research Partnership (NC-CCRP).

DeWitt Michael E ME Herrington David M DM Sanders John W JW

Research and practice in thrombosis and haemostasis 20230208 2

<h4>Background</h4>Although the incidence of venous and arterial thrombosis after a COVID-19 diagnosis and hospitalization has been well described using data available from electronic health records (EHR), little is known about their incidence after mild infections.<h4>Objectives</h4>To characterize the cumulative incidence and risk factors for thrombosis after a COVID-19 diagnosis among those identified through the EHR and those with a self-reported case.<h4>Methods</h4>We calculated the cumula ...[more]

PMID: 36777287

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Project description:Background: Thrombosis is a characteristic complication in coronavirus disease 2019 (COVID-19). Since coagulopathy has been observed over the entire clinical course, thrombosis might be a clue to understanding the specific pathology in COVID-19. Currently, there is limited epidemiological data of COVID-19-associated thrombosis in the Japanese population and none regarding variant strains of SARS-CoV-2. Here, we elucidate the risk factors and the pattern of thrombosis in COVID-19 patients. Methods: The patients consecutively admitted to Tokyo Medical and Dental University Hospital with COVID-19 were retrospectively analyzed. SARS-CoV-2 variants of concern/interest (VOC/VOI) carrying the spike protein mutants E484K, N501Y, or L452R were identified by PCR-based analysis. All thrombotic events were diagnosed by clinical symptoms, ultrasonography, and/or radiological tests. Results: Among the 516 patients, 32 patients experienced 42 thromboembolic events. Advanced age, severe respiratory conditions, and several abnormal laboratory markers were associated with the development of thrombosis. While thrombotic events occurred in 13% of the patients with a severe respiratory condition, those events still occurred in 2.5% of the patients who did not require oxygen therapy. Elevated D-dimer and ferritin levels on admission were independent risk factors of thrombosis (adjusted odds ratio 9.39 and 3.11, 95% confidence interval 2.08-42.3, and 1.06-9.17, respectively). Of the thrombotic events, 22 were venous, whereas 20 were arterial. While patients with thrombosis received anticoagulation and antiinflammatory therapies with a higher proportion, the mortality rate, organ dysfunctions, and bleeding complications in these patients were higher than those without thrombosis. The incidence of thrombosis in COVID-19 became less frequent over time, such as during the replacement of the earlier strains of SARS-CoV-2 by VOC/VOI and during increased use of anticoagulatory therapeutics. Conclusion: This study elucidated that elevated D-dimer and ferritin levels are useful biomarkers of thrombosis in COVID-19 patients. The comparable incidence of arterial thrombosis with venous thrombosis and the development of thrombosis in less severe patients required further considerations for the management of Japanese patients with COVID-19. Further studies would be required to identify high-risk populations and establish appropriate interventions for thrombotic complications in COVID-19.

Dataset Information

Venous or arterial thrombosis in COVID-19 cases in the North Carolina COVID-19 Community Research Partnership (NC-CCRP).

Background

Objectives

Methods

Results

Conclusion

Publications

Venous or arterial thrombosis in COVID-19 cases in the North Carolina COVID-19 Community Research Partnership (NC-CCRP).

Similar Datasets

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