Thrombosis in hospitalized patients with viral respiratory infections versus COVID-19 - 18/12/20
, Varun Subashchandran, BS, Eugene Yuriditsky, MD, James M. Horowitz, MD, Harmony R. Reynolds, MD, Judith S. Hochman, MD, Jeffrey S. Berger, MD, MS
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Riassunto |
We evaluated the incidence of thrombosis in patients hospitalized with non-COVID-19 acute viral respiratory illnesses nationwide from 2012 to 2014 and compared this to the incidence among patients hospitalized with COVID-19 at a large health system in New York. Non-COVID-19 viral respiratory illness was complicated by acute MI in 2.8% of hospitalizations, VTE in 1.6%, ischemic stroke in 0.7%, and other systemic embolism in 0.1%. The proportion of hospitalizations complicated by thrombosis was lower in patients with viral respiratory illness in 2002-2014 than in COVID-19 (5% vs 16%; P< .001).
Background |
Thrombosis is a prominent feature of the novel Coronavirus disease 2019 (COVID-19). The incidence of thrombosis during hospitalization for non-COVID-19 viral respiratory infections is uncertain. We evaluated the incidence of thrombosis in patients hospitalized with non-COVID-19 acute viral respiratory illnesses compared to COVID-19.
Methods |
Adults age >18 years hospitalized with a non-COVID-19 viral respiratory illness between 2002 and 2014 were identified. The primary study outcome was a composite of venous and arterial thrombotic events, including myocardial infarction (MI), acute ischemic stroke, and venous thromboembolism (VTE), as defined by ICD-9 codes. The incidence of thrombosis in non-COVID-19 viral respiratory illnesses was compared to the recently published incidence of thrombosis in COVID-19 from 3,334 patients hospitalized in New York in 2020.
Results |
Among 954,521 hospitalizations with viral pneumonia from 2002 to 2014 (mean age 62.3 years, 57.1% female), the combined incidence of arterial and venous thrombosis was 5.0%. Acute MI occurred in 2.8% of hospitalizations, VTE in 1.6%, ischemic stroke in 0.7%, and other systemic embolism in 0.1%. Patients with thrombosis had higher in-hospital mortality (14.9% vs 3.3%, P< .001) than those without thrombosis. The proportion of hospitalizations complicated by thrombosis was lower in patients with viral respiratory illness in 2002-2014 than in COVID-19 (median age 64; 39.6% female) in 2020 (5% vs 16%; P< .001)
Conclusion |
In a nationwide analysis of hospitalizations for viral pneumonias, thrombosis risk was lower than that observed in patients with COVID-19. Investigations into mechanisms of thrombosis and risk reduction strategies in COVID-19 and other viral respiratory infections are necessary.
Il testo completo di questo articolo è disponibile in PDF.Graphical abstract |
Mappa
| Disclosures: Dr. Smilowitz is supported by the National Heart, Lung, And Blood Institute of the National Institutes of Health under Award Number K23HL150315. Dr. Berger is funded, in part, by the National Heart and Lung Blood Institute of the National Institute of Health (R01HL139909 and R35HL144993). Dr. Horowitz serves as a consultant to Penumbra and Inari. The remaining authors have no disclosures to report. |
Vol 231
P. 93-95 - Gennaio 2021 Ritorno al numero
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