COVID-19-associated venous thromboembolism: risk of recurrence and major bleeding

Collaborators, Affiliations

Collaborators

RIETE Investigators:
M D Adarraga, A Alberich-Conesa, C Amado, S Amorós, J I Arcelus, A Ballaz, R Barba, C Barbagelata, M Barrón, B Barrón-Andrés, A Blanco-Molina, E Botella, R Carrero, I Casado, J Criado, J Del Toro, C De Ancos, C De Juana-Izquierdo, P Demelo-Rodríguez, A M Díaz-Brasero, M C Díaz-Pedroche, J A Díaz-Peromingo, A Dubois-Silva, J C Escribano, F Espósito, C Falgá, A I Farfán-Sedano, C Fernández-Capitán, B Fernández-Jiménez, J Fernández-Muixi, J L Fernández-Reyes, C Font, I Francisco, F Galeano-Valle, M A García, M García de Herreros, F García-Bragado, A García-Ortega, O Gavín-Sebastián, A Gil-Díaz, A Gil-Hernández, C Gómez-Cuervo, A M Gómez-Mosquera, J González-Martínez, E Grau, L Guirado, J Gutiérrez, L Hernández-Blasco, L Jara-Palomares, M J Jaras, D Jiménez, I Jou, M D Joya, B Lacruz, A Lalueza, S Lainez-Justo, R Lecumberri, J M León-Ramírez, J L Lobo, M López-De la Fuente, L López-Jiménez, P López-Miguel, J J López-Núñez, R López-Reyes, A López-Ruiz, J B López-Sáez, M A Lorente, A Lorenzo, M Lumbierres, O Madridano, A Maestre, L Mas-Maresma, M Marcos, J M Martín-Guerra, F Martín-Martos, M Mellado, E Mena, M I Mercado, J Moisés, M Monreal, A Muñoz-Blanco, G Muñoz-Gamito, J A Nieto, M J Núñez-Fernández, J Osorio, S Otalora, N Pacheco-Gómez, D Paredes-Ruiz, P Parra, J M Pedrajas, C Pérez-Ductor, A Pérez-Jacoiste, J L Pérez-Pérez, M L Peris, M L Pesce, J A Porras, J Poyo-Molina, R Puchades, A Riera-Mestre, F Rivera-Civico, A Rivera-Gallego, M Roca, C M Rubio, V Rosa, A Rodríguez-Cobo, N Ruiz-Giménez, J Ruiz-Ruiz, G Salgueiro, T Sancho, V Sendín, P Sigüenza, S Soler, J M Suriñach, G Tiberio, C Tolosa, M I Torres, J Trujillo-Santos, F Uresandi, E Usandizaga, R Valle, J F Varona, J R Vela, L Vela, G Vidal, A Villalobos, P Villares, C Ay, S Nopp, I Pabinger, M Engelen, C Martens, P Verhamme, H H B Yoo, J D Arguello, A C Montenegro, J Roa, J Hirmerova, R Malý, S Accassat, L Bertoletti, A Bura-Riviere, J Catella, R Chopard, F Couturaud, O Espitia, C Grange, B Leclercq, R Le Mao, I Mahé, F Moustafa, L Plaisance, G Poenou, G Sarlon-Bartoli, P Suchon, E Versini, S Schellong, A Braester, B Brenner, G Kenet, D Najib, I Tzoran, M Farrashi, P Sadeghipour, M Basaglia, F Bilora, C Bortoluzzi, B Brandolin, M Ciammaichella, D Colaizzo, F Dentali, P Di Micco, E Grandone, E Imbalzano, S Merla, R Pesavento, P Prandoni, P Scarinzi, C Siniscalchi, B Taflaj, A Tufano, A Visonà, N Vo Hong, B Zalunardo, S Fonseca, M Manuel, J Meireles, M Bosevski, A Eftimova, M Zdraveska, H Bounameaux, L Mazzolai, A Aujayeb, J A Caprini, I Weinberg, H M Bui

Affiliations

¹ Internal Medicine Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
² Respiratory Department, Virgen del Rocío Hospital and Instituto de Biomedicina, Sevilla, CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.
³ Department of Vascular Medicine, Hôpital de Rangueil, Toulouse, France.
⁴ Department of Vascular Medicine, Ospedale Castelfranco Veneto, Castelfranco Veneto, Italy.
⁵ Department of Internal Medicine, Hospital Universitari de Girona Dr. Josep Trueta, Gerona, Spain.
⁶ Department of Internal Medicine, Corporación Sanitaria Parc Taulí, Barcelona, Spain.
⁷ Department of Internal Medicine, Hospital Comarcal de Axarquía, Málaga, Spain.
⁸ Chair for the Study of Thromboembolic Disease, Faculty of Health Sciences, UCAM - Universidad Católica San Antonio de Murcia, Spain, CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain.

PMID: 37840687
PMCID: PMC10569976
DOI: 10.1016/j.rpth.2023.102206

COVID-19-associated venous thromboembolism: risk of recurrence and major bleeding

Pablo Demelo-Rodriguez et al. Res Pract Thromb Haemost. 2023.

. 2023 Sep 20;7(7):102206.

doi: 10.1016/j.rpth.2023.102206. eCollection 2023 Oct.

Collaborators

RIETE Investigators:
M D Adarraga, A Alberich-Conesa, C Amado, S Amorós, J I Arcelus, A Ballaz, R Barba, C Barbagelata, M Barrón, B Barrón-Andrés, A Blanco-Molina, E Botella, R Carrero, I Casado, J Criado, J Del Toro, C De Ancos, C De Juana-Izquierdo, P Demelo-Rodríguez, A M Díaz-Brasero, M C Díaz-Pedroche, J A Díaz-Peromingo, A Dubois-Silva, J C Escribano, F Espósito, C Falgá, A I Farfán-Sedano, C Fernández-Capitán, B Fernández-Jiménez, J Fernández-Muixi, J L Fernández-Reyes, C Font, I Francisco, F Galeano-Valle, M A García, M García de Herreros, F García-Bragado, A García-Ortega, O Gavín-Sebastián, A Gil-Díaz, A Gil-Hernández, C Gómez-Cuervo, A M Gómez-Mosquera, J González-Martínez, E Grau, L Guirado, J Gutiérrez, L Hernández-Blasco, L Jara-Palomares, M J Jaras, D Jiménez, I Jou, M D Joya, B Lacruz, A Lalueza, S Lainez-Justo, R Lecumberri, J M León-Ramírez, J L Lobo, M López-De la Fuente, L López-Jiménez, P López-Miguel, J J López-Núñez, R López-Reyes, A López-Ruiz, J B López-Sáez, M A Lorente, A Lorenzo, M Lumbierres, O Madridano, A Maestre, L Mas-Maresma, M Marcos, J M Martín-Guerra, F Martín-Martos, M Mellado, E Mena, M I Mercado, J Moisés, M Monreal, A Muñoz-Blanco, G Muñoz-Gamito, J A Nieto, M J Núñez-Fernández, J Osorio, S Otalora, N Pacheco-Gómez, D Paredes-Ruiz, P Parra, J M Pedrajas, C Pérez-Ductor, A Pérez-Jacoiste, J L Pérez-Pérez, M L Peris, M L Pesce, J A Porras, J Poyo-Molina, R Puchades, A Riera-Mestre, F Rivera-Civico, A Rivera-Gallego, M Roca, C M Rubio, V Rosa, A Rodríguez-Cobo, N Ruiz-Giménez, J Ruiz-Ruiz, G Salgueiro, T Sancho, V Sendín, P Sigüenza, S Soler, J M Suriñach, G Tiberio, C Tolosa, M I Torres, J Trujillo-Santos, F Uresandi, E Usandizaga, R Valle, J F Varona, J R Vela, L Vela, G Vidal, A Villalobos, P Villares, C Ay, S Nopp, I Pabinger, M Engelen, C Martens, P Verhamme, H H B Yoo, J D Arguello, A C Montenegro, J Roa, J Hirmerova, R Malý, S Accassat, L Bertoletti, A Bura-Riviere, J Catella, R Chopard, F Couturaud, O Espitia, C Grange, B Leclercq, R Le Mao, I Mahé, F Moustafa, L Plaisance, G Poenou, G Sarlon-Bartoli, P Suchon, E Versini, S Schellong, A Braester, B Brenner, G Kenet, D Najib, I Tzoran, M Farrashi, P Sadeghipour, M Basaglia, F Bilora, C Bortoluzzi, B Brandolin, M Ciammaichella, D Colaizzo, F Dentali, P Di Micco, E Grandone, E Imbalzano, S Merla, R Pesavento, P Prandoni, P Scarinzi, C Siniscalchi, B Taflaj, A Tufano, A Visonà, N Vo Hong, B Zalunardo, S Fonseca, M Manuel, J Meireles, M Bosevski, A Eftimova, M Zdraveska, H Bounameaux, L Mazzolai, A Aujayeb, J A Caprini, I Weinberg, H M Bui

Affiliations

¹ Internal Medicine Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
² Respiratory Department, Virgen del Rocío Hospital and Instituto de Biomedicina, Sevilla, CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.
³ Department of Vascular Medicine, Hôpital de Rangueil, Toulouse, France.
⁴ Department of Vascular Medicine, Ospedale Castelfranco Veneto, Castelfranco Veneto, Italy.
⁵ Department of Internal Medicine, Hospital Universitari de Girona Dr. Josep Trueta, Gerona, Spain.
⁶ Department of Internal Medicine, Corporación Sanitaria Parc Taulí, Barcelona, Spain.
⁷ Department of Internal Medicine, Hospital Comarcal de Axarquía, Málaga, Spain.
⁸ Chair for the Study of Thromboembolic Disease, Faculty of Health Sciences, UCAM - Universidad Católica San Antonio de Murcia, Spain, CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain.

PMID: 37840687
PMCID: PMC10569976
DOI: 10.1016/j.rpth.2023.102206

Abstract

Background: Complications under anticoagulant treatment in patients with COVID-19-associated venous thromboembolism (VTE) have not been consistently reported.

Objectives: This study aimed to compare the 90-day rates of VTE recurrences and major bleeding in patients with COVID-19-associated VTE versus those with VTE without COVID-19.

Methods: We used the RIETE registry to compare the 3-month outcomes in patients with COVID-19-associated VTE versus those with VTE without COVID-19.

Results: The study included 1,747 patients with COVID-19-associated VTE and 8,711 with VTE without COVID-19. Patients with COVID-19-associated VTE were more likely to be hospitalized at baseline and to present with pulmonary embolism. During the first 90 days, 123 patients (1.17%) developed VTE recurrences, and 266 (2.54%) experienced major bleeding. Patients with COVID-19-associated VTE had a similar rate of VTE recurrences (0.9% vs 1.2%) but a higher rate of major bleeding (4.6% vs 2.1%; P < .001) than those without COVID-19. Multivariable analysis adjusted for competing risks showed that patients with COVID-19-associated VTE had an increased risk of major bleeding (subhazard ratio, 1.395; 95% confidence interval, 1.037-1.877). The 30-day mortality after major bleeding was 26.3% in patients with COVID-19-associated VTE and 17.7% in those without COVID-19.

Conclusion: Patients with COVID-19-associated VTE had a 5-fold higher rate of major bleeding than VTE recurrences during the first 90 days of anticoagulation. In VTE patients without COVID-19, both rates were similar. These findings highlight the importance of carefully monitoring and optimizing anticoagulation in these patients.

Keywords: COVID-19; anticoagulants; hemorrhage; pulmonary embolism; venous thromboembolism.

PubMed Disclaimer

Figures

**Figure**
Ninety-day rates of major bleeding and VTE recurrences (Fine and Gray regression). Recurrences and major bleedings at day 7, 15, 30, 60, and 90. VTE, venous thromboembolism.

See this image and copyright information in PMC

References

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1. Demelo-Rodríguez P., Cervilla-Muñoz E., Ordieres-Ortega L., Parra-Virto A., Toledano-Macías M., Toledo-Samaniego N., et al. Incidence of asymptomatic deep vein thrombosis in patients with COVID-19 pneumonia and elevated D-dimer levels. Thromb Res. 2020;192:23–26. - PMC - PubMed
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1. Fernández-Capitán C., Barba R., Díaz-Pedroche M.D.C., Sigüenza P., Demelo-Rodriguez P., Siniscalchi C., et al. Presenting characteristics, treatment patterns, and outcomes among patients with venous thromboembolism during hospitalization for COVID-19. Semin Thromb Hemost. 2021;47:351–361. - PubMed

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COVID-19-associated venous thromboembolism: risk of recurrence and major bleeding

Collaborators

Affiliations

COVID-19-associated venous thromboembolism: risk of recurrence and major bleeding

Authors

Collaborators

Affiliations

Abstract

Figures

References

LinkOut - more resources

Full Text Sources