Dataset Information

High Risk of Secondary Infections Following Thrombotic Complications in Patients With COVID-19.

ABSTRACT:

Background

This study's primary aim was to evaluate the impact of thrombotic complications on the development of secondary infections. The secondary aim was to compare the etiology of secondary infections in patients with and without thrombotic complications.

Methods

This was a cohort study (NCT04318366) of coronavirus disease 2019 (COVID-19) patients hospitalized at IRCCS San Raffaele Hospital between February 25 and June 30, 2020. Incidence rates (IRs) were calculated by univariable Poisson regression as the number of cases per 1000 person-days of follow-up (PDFU) with 95% confidence intervals. The cumulative incidence functions of secondary infections according to thrombotic complications were compared with Gray's method accounting for competing risk of death. A multivariable Fine-Gray model was applied to assess factors associated with risk of secondary infections.

Results

Overall, 109/904 patients had 176 secondary infections (IR, 10.0; 95% CI, 8.8-11.5; per 1000-PDFU). The IRs of secondary infections among patients with or without thrombotic complications were 15.0 (95% CI, 10.7-21.0) and 9.3 (95% CI, 7.9-11.0) per 1000-PDFU, respectively (P = .017). At multivariable analysis, thrombotic complications were associated with the development of secondary infections (subdistribution hazard ratio, 1.788; 95% CI, 1.018-3.140; P = .043). The etiology of secondary infections was similar in patients with and without thrombotic complications.

Conclusions

In patients with COVID-19, thrombotic complications were associated with a high risk of secondary infections.

SUBMITTER: Ripa M

PROVIDER: S-EPMC9511118 | biostudies-literature | 2022 Sep

REPOSITORIES: biostudies-literature

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Publications

High Risk of Secondary Infections Following Thrombotic Complications in Patients With COVID-19.

Ripa Marco M Galli Laura L D'Angelo Armando A Apruzzi Luca L Palumbo Diego D Campochiaro Corrado C Tassan Din Chiara C Danise Anna A Da Prat Valentina V Vitali Giordano G Brugliera Luigia L Poli Andrea A Monardo Roberta R Monti Giacomo G Baccellieri Domenico D De Cobelli Francesco F Clementi Massimo M Iannaccone Sandro S Dagna Lorenzo L Rovere-Querini Patrizia P Ciceri Fabio F Tresoldi Moreno M Zangrillo Alberto A Scarpellini Paolo P Castagna Antonella A

Open forum infectious diseases 20220902 9

<h4>Background</h4>This study's primary aim was to evaluate the impact of thrombotic complications on the development of secondary infections. The secondary aim was to compare the etiology of secondary infections in patients with and without thrombotic complications.<h4>Methods</h4>This was a cohort study (NCT04318366) of coronavirus disease 2019 (COVID-19) patients hospitalized at IRCCS San Raffaele Hospital between February 25 and June 30, 2020. Incidence rates (IRs) were calculated by univari ...[more]

PMID: 36168552

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Project description:BackgroundOptimal prophylactic and therapeutic management of thromboembolic disease in patients with COVID-19 remains a major challenge for clinicians. The aim of this study was to define the incidence of thrombotic and haemorrhagic complications in critically ill patients with COVID-19. In addition, we sought to characterise coagulation profiles using thromboelastography and explore possible biological differences between patients with and without thrombotic complications.MethodsWe conducted a multicentre retrospective observational study evaluating all the COVID-19 patients received in four intensive care units (ICUs) of four tertiary hospitals in the UK between March 15, 2020, and May 05, 2020. Clinical characteristics, laboratory data, thromboelastography profiles and clinical outcome data were evaluated between patients with and without thrombotic complications.ResultsA total of 187 patients were included. Their median (interquartile (IQR)) age was 57 (49-64) years and 124 (66.3%) patients were male. Eighty-one (43.3%) patients experienced one or more clinically relevant thrombotic complications, which were mainly pulmonary emboli (n = 42 (22.5%)). Arterial embolic complications were reported in 25 (13.3%) patients. ICU length of stay was longer in patients with thrombotic complications when compared with those without. Fifteen (8.0%) patients experienced haemorrhagic complications, of which nine (4.8%) were classified as major bleeding. Thromboelastography demonstrated a hypercoagulable profile in patients tested but lacked discriminatory value between those with and without thrombotic complications. Patients who experienced thrombotic complications had higher D-dimer, ferritin, troponin and white cell count levels at ICU admission compared with those that did not.ConclusionCritically ill patients with COVID-19 experience high rates of venous and arterial thrombotic complications. The rates of bleeding may be higher than previously reported and re-iterate the need for randomised trials to better understand the risk-benefit ratio of different anticoagulation strategies.

Dataset Information

High Risk of Secondary Infections Following Thrombotic Complications in Patients With COVID-19.

Background

Methods

Results

Conclusions

Publications

High Risk of Secondary Infections Following Thrombotic Complications in Patients With COVID-19.

Similar Datasets

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