PDF(Pubmed)
Abstract：
Thromboprophylaxis/anticoagulation treatment is often required in hospitalized COVID-19 patients. We aimed to estimate the prevalence of major bleeding events in hospitalized COVID-19 patients. This was a retrospective observational study including all COVID-19 hospitalized patients ≥18 years of age at one reference center in northern Italy. The crude prevalence (between February 2020-2022) of major bleeding events was estimated as the number of major bleeding episodes divided by patients at risk. Uni- and multivariable Cox models were built to assess factors potentially associated with major bleeding events. Twenty-nine (0.98%) out of 2,945 COVID-19 patients experienced a major bleeding event [prevalence of 0.55% (95%CI 0.37-0.79)], of which five were fatal. Patients who experienced a major bleeding event were older [78 years (72-84 IQR) vs. 67 years (55-78 IQR), p-value < 0.001] and more frequently exposed to anti-aggregating therapy (44.8% vs. 20.0%, p-value 0.002) when compared to those who did not. In the multivariable Cox model, age [per 1 year more AHR 1.05 (CI95% 1.02-1.09)] was independently associated with an increased risk of major bleeding events. A strict monitoring of older hospitalized COVID-19 patients is warranted due to the risk of major bleeding events.
摘要：
住院COVID-19患者通常需要血栓预防/抗凝治疗。我们旨在评估住院COVID-19患者大出血事件的发生率。这是一项回顾性观察性研究，包括意大利北部一个参考中心的所有≥18岁的COVID-19住院患者。大出血事件的粗患病率（2020年2月至2022年）估计为大出血事件的数量除以有风险的患者。建立单变量和多变量Cox模型以评估可能与大出血事件相关的因素。2,945例COVID-19患者中有29例（0.98%）经历了大出血事件[患病率为0.55%（95CI0.37-0.79）]，其中五个是致命的。经历大出血事件的患者年龄较大[78岁（72-84IQR）与67岁（55-78IQR），p值<0.001]和更频繁地暴露于抗聚集治疗(44.8%vs.20.0%,p值0.002）与没有的人相比。在多变量Cox模型中，年龄[每增加1年AHR1.05(CI95%1.02-1.09)]与大出血事件风险增加独立相关.由于存在严重出血事件的风险，因此有必要对老年住院COVID-19患者进行严格监测。
