COVID-19 患者发生动脉和静脉血栓事件的风险:加拿大、欧洲和美国监管机构的跨国合作。

IF 3.4 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Clinical Epidemiology Pub Date : 2024-02-10 eCollection Date: 2024-01-01 DOI:10.2147/CLEP.S448980
Vincent Lo Re Iii, Noelle M Cocoros, Rebecca A Hubbard, Sarah K Dutcher, Craig W Newcomb, John G Connolly, Silvia Perez-Vilar, Dena M Carbonari, Maria E Kempner, José J Hernández-Muñoz, Andrew B Petrone, Allyson M Pishko, Meighan E Rogers Driscoll, James T Brash, Sean Burnett, Catherine Cohet, Matthew Dahl, Terese A DeFor, Antonella Delmestri, Djeneba Audrey Djibo, Talita Duarte-Salles, Laura B Harrington, Melissa Kampman, Jennifer L Kuntz, Xavier Kurz, Núria Mercadé-Besora, Pamala A Pawloski, Peter R Rijnbeek, Sarah Seager, Claudia A Steiner, Katia Verhamme, Fangyun Wu, Yunping Zhou, Edward Burn, J Michael Paterson, Daniel Prieto-Alhambra
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引用次数: 0

摘要

目的:很少有研究探讨 COVID-19 在不同国家的血栓栓塞绝对风险是如何随时间演变的。来自欧洲药品管理局、加拿大卫生部和美国食品药品管理局的研究人员建立了一项合作,以评估 COVID-19 疫苗上市前和上市期间,北美(加拿大、美国)和欧洲(英国、德国、意大利、荷兰和西班牙)七个国家的非卧床(如门诊、急诊科、护理机构)环境中确诊 COVID-19 后 90 天内动脉 (ATE) 和静脉血栓栓塞 (VTE) 的绝对风险:我们对七个特定国家最初在门诊诊断为 COVID-19 的患者进行了队列研究。在确诊 COVID-19 后,我们对患者进行了 90 天的随访。主要结果是确诊后 90 天内的 ATE 和 VTE。我们测量了国家层面的 90 天 ATE 和 VTE 绝对风险估计值(含 95% 置信区间):七个队列共纳入了 1,061,565 名在 COVID-19 疫苗上市前(截至 2020 年 11 月)在门诊环境中被初步诊断为 COVID-19 的患者。在此期间,90天ATE绝对风险从加拿大的0.11%(0.09-0.13%)到美国的1.01%(0.97-1.05%)不等,90天VTE绝对风险从加拿大的0.23%(0.21-0.26%)到英国的0.84%(0.80-0.89%)不等。七个队列共纳入了3,544,062名在疫苗上市期间(2020年12月开始)接种COVID-19的患者。在此期间,90天ATE绝对风险从英国的0.06%(0.06-0.07%)到美国的1.04%(1.01-1.06%)不等,90天VTE绝对风险从英国的0.25%(0.24-0.26%)到美国的1.02%(0.99-1.04%)不等:结论:在COVID-19疫苗上市前和上市期间,各国在门诊诊断出COVID-19后90天内发生ATE和VTE的绝对风险存在异质性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Risk of Arterial and Venous Thrombotic Events Among Patients with COVID-19: A Multi-National Collaboration of Regulatory Agencies from Canada, Europe, and United States.

Purpose: Few studies have examined how the absolute risk of thromboembolism with COVID-19 has evolved over time across different countries. Researchers from the European Medicines Agency, Health Canada, and the United States (US) Food and Drug Administration established a collaboration to evaluate the absolute risk of arterial (ATE) and venous thromboembolism (VTE) in the 90 days after diagnosis of COVID-19 in the ambulatory (eg, outpatient, emergency department, nursing facility) setting from seven countries across North America (Canada, US) and Europe (England, Germany, Italy, Netherlands, and Spain) within periods before and during COVID-19 vaccine availability.

Patients and methods: We conducted cohort studies of patients initially diagnosed with COVID-19 in the ambulatory setting from the seven specified countries. Patients were followed for 90 days after COVID-19 diagnosis. The primary outcomes were ATE and VTE over 90 days from diagnosis date. We measured country-level estimates of 90-day absolute risk (with 95% confidence intervals) of ATE and VTE.

Results: The seven cohorts included 1,061,565 patients initially diagnosed with COVID-19 in the ambulatory setting before COVID-19 vaccines were available (through November 2020). The 90-day absolute risk of ATE during this period ranged from 0.11% (0.09-0.13%) in Canada to 1.01% (0.97-1.05%) in the US, and the 90-day absolute risk of VTE ranged from 0.23% (0.21-0.26%) in Canada to 0.84% (0.80-0.89%) in England. The seven cohorts included 3,544,062 patients with COVID-19 during vaccine availability (beginning December 2020). The 90-day absolute risk of ATE during this period ranged from 0.06% (0.06-0.07%) in England to 1.04% (1.01-1.06%) in the US, and the 90-day absolute risk of VTE ranged from 0.25% (0.24-0.26%) in England to 1.02% (0.99-1.04%) in the US.

Conclusion: There was heterogeneity by country in 90-day absolute risk of ATE and VTE after ambulatory COVID-19 diagnosis both before and during COVID-19 vaccine availability.

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来源期刊
Clinical Epidemiology
Clinical Epidemiology Medicine-Epidemiology
CiteScore
6.30
自引率
5.10%
发文量
169
审稿时长
16 weeks
期刊介绍: Clinical Epidemiology is an international, peer reviewed, open access journal. Clinical Epidemiology focuses on the application of epidemiological principles and questions relating to patients and clinical care in terms of prevention, diagnosis, prognosis, and treatment. Clinical Epidemiology welcomes papers covering these topics in form of original research and systematic reviews. Clinical Epidemiology has a special interest in international electronic medical patient records and other routine health care data, especially as applied to safety of medical interventions, clinical utility of diagnostic procedures, understanding short- and long-term clinical course of diseases, clinical epidemiological and biostatistical methods, and systematic reviews. When considering submission of a paper utilizing publicly-available data, authors should ensure that such studies add significantly to the body of knowledge and that they use appropriate validated methods for identifying health outcomes. The journal has launched special series describing existing data sources for clinical epidemiology, international health care systems and validation studies of algorithms based on databases and registries.
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