COVID-19和复发性静脉血栓栓塞(CORE-VTE)。

The Canadian journal of hospital pharmacy Pub Date : 2025-07-09 eCollection Date: 2025-01-01 DOI:10.4212/cjhp.3702
Jesalyn Clarkson, Micheal Guirguis, Xueyi Chen, Timothy Chan, Priya Samuel, Tammy J Bungard
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引用次数: 0

摘要

背景:静脉血栓栓塞(VTE)事件与COVID-19相关,抗凝治疗的最佳持续时间尚不确定。目的:主要目的是确定covid -19相关静脉血栓栓塞后使用抗凝药物处方的时间和静脉血栓栓塞复发的患者比例。次要目的是确定发生出血事件的患者比例。方法:本回顾性队列研究分析了2020年2月23日至2022年6月30日在加拿大艾伯塔省确诊的covid -19相关静脉血栓栓塞病例的数据。使用《国际疾病分类》第九版的代码和艾伯塔省卫生服务程序代码来确定静脉血栓栓塞门诊病例。静脉血栓栓塞和出血事件的住院病例使用国际疾病和相关健康问题分类第10版中的代码进行鉴定。结果:纳入分析的822例患者中,中位随访时间为359.0天,大部分随访发生在患者停药期间(中位随访时间为273.0天)。年龄中位数为59岁,男性占61.9%,有肺栓塞82.1%,未接种COVID-19疫苗71.9%,Charlson合并症指数中位数为1分。中位疗程为100.0天(四分位数间距71.0 ~ 190.0),其中360例(43.8%)患者服药0-3个月,234例(28.5%)服药4-6个月,181例(22.0%)服药7-12个月,47例(5.7%)服药超过12个月。总体而言,49例(6.0%)患者发生静脉血栓栓塞复发,其中24例患者在事件发生前持续服用抗凝药物。出血72例(8.8%)。结论:考虑到大多数患者停用抗凝治疗的随访时间较长,考虑3-6个月治疗covid -19相关性静脉血栓栓塞是合理的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
COVID-19 and Recurrent Venous Thromboembolism (CORE-VTE).

Background: Venous thromboembolism (VTE) events occur in association with COVID-19, and the optimal duration of anticoagulant treatment is uncertain.

Objectives: The primary objectives were to determine the duration of anticoagulant prescriptions filled after COVID-19-associated VTE and the proportion of patients experiencing VTE recurrence. The secondary objective was to determine the proportion of patients who experienced bleeding events.

Methods: This retrospective cohort study analyzed data for cases of COVID-19-associated VTE across Alberta, Canada, confirmed between February 23, 2020, and June 30, 2022. Outpatient cases of VTE were identified using codes from the International Classification of Diseases, Ninth Revision plus Alberta Health Service procedure codes. Inpatient cases of VTE and bleeding events were identified using codes from the International Classification of Diseases and Related Health Problems, 10th Revision.

Results: Among the 822 patients included in the analysis, median follow-up was 359.0 days, with the majority of follow-up occurring while patients were off treatment (median 273.0 days). The median age was 59 years, 61.9% of the patients were male, 82.1% had a pulmonary embolism, 71.9% had not received COVID-19 vaccinations, and the median Charlson comorbidity index score was 1. The median duration of treatment was 100.0 (interquartile range 71.0-190.0) days, with 360 patients (43.8%) filling their prescriptions for 0-3 months, 234 (28.5%) for 4-6 months, 181 (22.0%) for 7-12 months, and 47 (5.7%) for more than 12 months. Overall, recurrent VTE occurred in 49 patients (6.0%), 24 of whom had continuously filled their anticoagulant prescriptions up to the time of the event. Bleeding occurred in 72 patients (8.8%).

Conclusions: Given the prolonged follow-up period off anticoagulant treatment for most patients, it is reasonable to consider 3-6 months of therapy for COVID-19-associated VTE.

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