Thromboembolic Complications in COVID-19 Patients Hospitalized in Italian Ordinary Wards: Data from the Multicenter Observational START-COVID Register

Daniela Poli; Emilia Antonucci; Walter Ageno; Paolo Prandoni; Giovanni Barillari; Giuseppina Bitti; Egidio Imbalzano; Eugenio Bucherini; Antonio Chistolini; Vittorio Fregoni; Silvia Galliazzo; Alberto Gandolfo; Elisa Grifoni; Franco Mastroianni; Serena Panarello; Raffaele Pesavento; Simona Pedrini; Girolamo Sala; Pasquale Pignatelli; Paola Preti; Federico Simonetti; Piera Sivera; Adriana Visonà; Sabina Villalta; Rossella Marcucci; Gualtiero Palareti

doi:10.1055/a-1878-6806

TH Open, Inhaltsverzeichnis

CC BY 4.0 · TH Open 2022; 06(03): e251-e256
DOI: 10.1055/a-1878-6806

Original Article

Thromboembolic Complications in COVID-19 Patients Hospitalized in Italian Ordinary Wards: Data from the Multicenter Observational START-COVID Register

Daniela Poli

¹SOD Malattie Aterotrombotiche, Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy

,

Emilia Antonucci

²Fondazione Arianna Anticoagulazione, Bologna, Italy

,

Walter Ageno

³Dipartimento di Medicina e Chirurgia, Università dell'Insubria, Varese, Italy

,

Paolo Prandoni

²Fondazione Arianna Anticoagulazione, Bologna, Italy

,

Giovanni Barillari

⁴Medicina Trasfusionale ASU FC Udine

,

Giuseppina Bitti

⁵Medicina Interna Ospedale Civile di Fermo, Fermo, Italy

,

Egidio Imbalzano

⁶A.O.U. G. Martino, Università di Messina, Messina, Italy

,

Eugenio Bucherini

⁷SS Az.le di Angiologia AUSL Romagna, Faenza (RA), Italy

,

Antonio Chistolini

⁸Dipartimento di Medicina Traslazionale e di Precisione, Sapienza Università di Roma, Roma, Italy

,

Vittorio Fregoni

⁹U.O.C. Medicina Generale, ASST Valtellina e Alto Lario Ospedale di Sondalo, Italy

,

Silvia Galliazzo

¹⁰UOC Medicina Generale, Ospedale San Valentino, Montebelluna (TV), Italy

,

Alberto Gandolfo

¹¹SC (UCO) Clinica Medica, ASUGI, Ospedale di Cattinara, Trieste, Italy

,

Elisa Grifoni

¹²Medicina Interna 2, Ospedale San Giuseppe, Empoli (Fi), Italy

,

Franco Mastroianni

¹³UOC Medicina Interna, Covid Unit, EE Ospedale F. Miulli, Acquaviva delle Fonti (Ba), Italy

,

Serena Panarello

¹⁴SC Medicina Interna, Ospedale Galliera Genova, Italy

,

Raffaele Pesavento

¹⁵UO Clinica Medica 3 Azienda Ospedaliero Universitaria Padova, Italy

,

Simona Pedrini

¹⁶UO, laboratorio Analisi, Fondazione Poliambulanza Brescia, Italy

,

Girolamo Sala

¹⁷UOC Medicina II, Ospedale di Circolo Busto Arsizio (Va), Italy

,

Pasquale Pignatelli

¹⁸I Clinica Medica, Medicina Interna Covid e Centro Trombosi Sapienza, Università di Roma, Roma, Italy

,

Paola Preti

¹⁹Unità di Medicina Interna, Malattie Vascolari e Metaboliche Policlinico San Matteo, Pavia, Italy

,

Federico Simonetti

²⁰UOC Ematologia Aziendale – Ospedale Versilia –Lido di Camaiore (Lucca), Italy

,

Piera Sivera

²¹SCDU Ematologia e terapie cellulari, AO Ordine Mauriziano Umberto 1° Torino, Italy

,

Adriana Visonà

²²UOC Angiologia, Ospedale San Giacomo Apostolo, Castelfranco Veneto (Treviso), Italy

,

Sabina Villalta

²³UOC Medicina Generale, Ospedale San Giacomo Apostolo, Castelfranco Veneto (Treviso), Italy

,

Rossella Marcucci

¹SOD Malattie Aterotrombotiche, Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy

²⁴Department of Experimental and Clinical Medicine, University of Florence, Firenze, Italy

,

Gualtiero Palareti

²Fondazione Arianna Anticoagulazione, Bologna, Italy

› Institutsangaben

Abstract

Background Coronavirus disease 2019 (COVID-19) infection causes acute respiratory insufficiency with severe interstitial pneumonia and extrapulmonary complications; in particular, it may predispose to thromboembolic disease. The reported incidence of thromboembolic complications varies from 5 to 30% of cases.

Aim We conducted a multicenter, Italian, retrospective, observational study on COVID-19 patients admitted to ordinary wards, to describe the clinical characteristics of patients at admission and bleeding and thrombotic events occurring during the hospital stay.

Results The number of hospitalized patients included in the START-COVID-19 Register was 1,135, and the number of hospitalized patients in ordinary wards included in the study was 1,091, with 653 (59.9%) being males and 71 years (interquartile range 59–82 years) being the median age. During the observation, two (0.2%) patients had acute coronary syndrome episodes and one patient (0.1%) had an ischemic stroke; no other arterial thrombotic events were recorded. Fifty-nine patients had symptomatic venous thromboembolism (VTE) (5.4%) events, 18 (30.5%) deep vein thrombosis (DVT), 39 (66.1%) pulmonary embolism (PE), and 2 (3.4%) DVT+PE. Among patients with DVT, eight (44.4%) were isolated distal DVT and two cases were jugular thrombosis. Among patients with PE, seven (17.9%) events were limited to subsegmental arteries. No fatal PE was recorded. Major bleeding events occurred in nine (1.2%) patients and clinically relevant nonmajor bleeding events in nine (1.2%) patients. All bleeding events occurred among patients receiving thromboprophylaxis, more frequently when treated with subtherapeutic or therapeutic dosages.

Conclusion Our findings confirm that patients admitted to ordinary wards for COVID-19 infection are at high risk for thromboembolic events. VTE recorded among these patients is mainly isolated PE, suggesting a peculiar characteristic of VTE in these patients.

Keywords

COVID-19 - venous thromboembolism - bleeding - thromboprophylaxis

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Referenzen

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