tetano
Editor, Senior Moderator
Res Pract Thromb Haemost
. 2021 Feb 17;10.1002/rth2.12496.
doi: 10.1002/rth2.12496. Online ahead of print.
Risk of thrombotic complications in influenza versus COVID-19 hospitalized patients
Mam Stals[SUP] 1 [/SUP], Mjjh Grootenboers[SUP] 2 [/SUP], C van Guldener[SUP] 3 [/SUP], Fhj Kaptein[SUP] 1 [/SUP], Sje Braken[SUP] 1 [/SUP], Q Chen[SUP] 4 [/SUP], G Chu[SUP] 1 [/SUP], E M van Driel[SUP] 5 [/SUP], A Iglesias Del Sol[SUP] 6 [/SUP], E de Jonge[SUP] 7 [/SUP], K M Kant[SUP] 8 [/SUP], F Pals[SUP] 1 [/SUP], Mma Toorop[SUP] 4 [/SUP], S C Cannegieter[SUP] 1 4 [/SUP], F A Klok[SUP] 1 [/SUP], M V Huisman[SUP] 1 [/SUP], Dutch COVID, Thrombosis Coalition (DCTC)
Affiliations
Abstract
Background: Whereas accumulating studies on COVID-19 patients report high incidences of thrombotic complications, large studies on clinically relevant thrombosis in patients with other respiratory tract infections are lacking. How this high risk in COVID-19 patients compares to those observed in hospitalized patients with other viral pneumonias such as influenza is unknown.
Objectives: To assess the incidence of venous and arterial thrombotic complications in hospitalized influenza patients as opposed to that observed in hospitalized COVID-19 patients.
Methods: Retrospective cohort study; we used data from Statistics Netherlands (study period: 2018) on thrombotic complications in hospitalized influenza patients. In parallel, we assessed the cumulative incidence of thrombotic complications - adjusted for competing risk of death - in patients with COVID-19 in three Dutch hospitals (February 24th - April 26th 2020).
Results: Of the 13.217 hospitalized influenza patients, 437 (3.3%) were diagnosed with thrombotic complications, versus 66 (11%) of the 579 hospitalized COVID-19 patients. The 30-day cumulative incidence of any thrombotic complication in influenza was 11% (95%CI 9.4-12) versus 25% (95%CI 18-32) in COVID-19. For venous thrombotic complications (VTE) and arterial thrombotic complications alone, these numbers were respectively 3.6% (95%CI 2.7-4.6) and 7.5% (95%CI 6.3-8.8) in influenza versus 23% (95%CI 16-29) and 4.4% (95%CI 1.9-8.8) in COVID-19.
Conclusions: The incidence of thrombotic complications in hospitalized influenza patients was lower than in hospitalized COVID-19 patients. This difference was mainly driven by a high risk of VTE complications in the COVID-19 patients admitted to ICU. Remarkably, influenza patients were more often diagnosed with arterial thrombotic complications.
Keywords: COVID?19; Human; Incidence; Influenza; Pneumonia; Thrombosis; Viral.
. 2021 Feb 17;10.1002/rth2.12496.
doi: 10.1002/rth2.12496. Online ahead of print.
Risk of thrombotic complications in influenza versus COVID-19 hospitalized patients
Mam Stals[SUP] 1 [/SUP], Mjjh Grootenboers[SUP] 2 [/SUP], C van Guldener[SUP] 3 [/SUP], Fhj Kaptein[SUP] 1 [/SUP], Sje Braken[SUP] 1 [/SUP], Q Chen[SUP] 4 [/SUP], G Chu[SUP] 1 [/SUP], E M van Driel[SUP] 5 [/SUP], A Iglesias Del Sol[SUP] 6 [/SUP], E de Jonge[SUP] 7 [/SUP], K M Kant[SUP] 8 [/SUP], F Pals[SUP] 1 [/SUP], Mma Toorop[SUP] 4 [/SUP], S C Cannegieter[SUP] 1 4 [/SUP], F A Klok[SUP] 1 [/SUP], M V Huisman[SUP] 1 [/SUP], Dutch COVID, Thrombosis Coalition (DCTC)
Affiliations
- PMID: 33821230
- PMCID: PMC8014477
- DOI: 10.1002/rth2.12496
Abstract
Background: Whereas accumulating studies on COVID-19 patients report high incidences of thrombotic complications, large studies on clinically relevant thrombosis in patients with other respiratory tract infections are lacking. How this high risk in COVID-19 patients compares to those observed in hospitalized patients with other viral pneumonias such as influenza is unknown.
Objectives: To assess the incidence of venous and arterial thrombotic complications in hospitalized influenza patients as opposed to that observed in hospitalized COVID-19 patients.
Methods: Retrospective cohort study; we used data from Statistics Netherlands (study period: 2018) on thrombotic complications in hospitalized influenza patients. In parallel, we assessed the cumulative incidence of thrombotic complications - adjusted for competing risk of death - in patients with COVID-19 in three Dutch hospitals (February 24th - April 26th 2020).
Results: Of the 13.217 hospitalized influenza patients, 437 (3.3%) were diagnosed with thrombotic complications, versus 66 (11%) of the 579 hospitalized COVID-19 patients. The 30-day cumulative incidence of any thrombotic complication in influenza was 11% (95%CI 9.4-12) versus 25% (95%CI 18-32) in COVID-19. For venous thrombotic complications (VTE) and arterial thrombotic complications alone, these numbers were respectively 3.6% (95%CI 2.7-4.6) and 7.5% (95%CI 6.3-8.8) in influenza versus 23% (95%CI 16-29) and 4.4% (95%CI 1.9-8.8) in COVID-19.
Conclusions: The incidence of thrombotic complications in hospitalized influenza patients was lower than in hospitalized COVID-19 patients. This difference was mainly driven by a high risk of VTE complications in the COVID-19 patients admitted to ICU. Remarkably, influenza patients were more often diagnosed with arterial thrombotic complications.
Keywords: COVID?19; Human; Incidence; Influenza; Pneumonia; Thrombosis; Viral.