Postdischarge venous thromboembolism following hospital admission with COVID-19.
Betacoronavirus
/ isolation & purification
COVID-19
Coronavirus Infections
/ complications
Follow-Up Studies
Hospitalization
/ statistics & numerical data
Humans
Pandemics
Patient Discharge
/ statistics & numerical data
Pneumonia, Viral
/ complications
Prognosis
SARS-CoV-2
Venous Thromboembolism
/ etiology
Journal
Blood
ISSN: 1528-0020
Titre abrégé: Blood
Pays: United States
ID NLM: 7603509
Informations de publication
Date de publication:
10 09 2020
10 09 2020
Historique:
received:
10
07
2020
accepted:
29
07
2020
pubmed:
4
8
2020
medline:
6
10
2020
entrez:
4
8
2020
Statut:
ppublish
Résumé
The association of severe coronavirus disease 2019 (COVID-19) with an increased risk of venous thromboembolism (VTE) has resulted in specific guidelines for its prevention and management. The VTE risk appears highest in those with critical care admission. The need for postdischarge thromboprophylaxis remains controversial, which is reflected in conflicting expert guideline recommendations. Our local protocol provides thromboprophylaxis to COVID-19 patients during admission only. We report postdischarge VTE data from an ongoing quality improvement program incorporating root-cause analysis of hospital-associated VTE (HA-VTE). Following 1877 hospital discharges associated with COVID-19, 9 episodes of HA-VTE were diagnosed within 42 days, giving a postdischarge rate of 4.8 per 1000 discharges. Over 2019, following 18 159 discharges associated with a medical admission; there were 56 episodes of HA-VTE within 42 days (3.1 per 1000 discharges). The odds ratio for postdischarge HA-VTE associated with COVID-19 compared with 2019 was 1.6 (95% confidence interval, 0.77-3.1). COVID-19 hospitalization does not appear to increase the risk of postdischarge HA-VTE compared with hospitalization with other acute medical illness. Given that the risk-benefit ratio of postdischarge thromboprophylaxis remains uncertain, randomized controlled trials to evaluate the role of continuing thromboprophylaxis in COVID-19 patients following hospital discharge are required.
Identifiants
pubmed: 32746455
pii: S0006-4971(20)61730-X
doi: 10.1182/blood.2020008086
pmc: PMC7483432
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1347-1350Informations de copyright
© 2020 by The American Society of Hematology.
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