tetano
Editor, Senior Moderator
Thromb Res
. 2024 May:237:209-215.
doi: 10.1016/j.thromres.2024.02.021. Epub 2024 Apr 6. Low absolute risk of thrombotic and cardiovascular events in outpatient pregnant women with COVID-19
Behnood Bikdeli[SUP] 1 [/SUP], Darsiya Krishnathasan[SUP] 2 [/SUP], Candrika D Khairani[SUP] 2 [/SUP], Antoine Bejjani[SUP] 2 [/SUP], Julia Davies[SUP] 2 [/SUP], Nicole Porio[SUP] 2 [/SUP], Anthony Tristani[SUP] 2 [/SUP], Andre Armero[SUP] 2 [/SUP], Ali A Assi[SUP] 3 [/SUP], Victor Nauffal[SUP] 4 [/SUP], Umberto Campia[SUP] 2 [/SUP], Zaid Almarzooq[SUP] 4 [/SUP], Eric Wei[SUP] 4 [/SUP], Marcos D Ortiz-Rios[SUP] 5 [/SUP], Valeria Zuluaga-Sánchez[SUP] 6 [/SUP], Aditya Achanta[SUP] 7 [/SUP], Sirus J Jesudasen[SUP] 8 [/SUP], Bruce Tiu[SUP] 6 [/SUP], Geno J Merli[SUP] 9 [/SUP], Orly Leiva[SUP] 5 [/SUP], John Fanikos[SUP] 10 [/SUP], Elvira Grandone[SUP] 11 [/SUP], Aditya Sharma[SUP] 12 [/SUP], Samantha Rizzo[SUP] 6 [/SUP], Mariana B Pfeferman[SUP] 6 [/SUP], Ruth B Morrison[SUP] 2 [/SUP], Alec Vishnevsky[SUP] 9 [/SUP], Judith Hsia[SUP] 13 [/SUP], Mark R Nehler[SUP] 14 [/SUP], James Welker[SUP] 15 [/SUP], Marc P Bonaca[SUP] 13 [/SUP], Brett Carroll[SUP] 16 [/SUP], Samuel Z Goldhaber[SUP] 2 [/SUP], Zhou Lan[SUP] 17 [/SUP], Gregory Piazza[SUP] 18 [/SUP]; CORONA-VTE-Network Investigators
Affiliations
Introduction: Pregnancy may contribute to an excess risk of thrombotic or cardiovascular events. COVID-19 increases the risk of these events, although the risk is relatively limited among outpatients. We sought to determine whether outpatient pregnant women with COVID-19 are at a high risk for cardiovascular or thrombotic events.
Materials & methods: We analyzed pregnant outpatients with COVID-19 from the multicenter CORONA-VTE-Network registry. The main study outcomes were a composite of adjudicated venous or arterial thrombotic events, and a composite of adjudicated cardiovascular events. Events were assessed 90 days after the COVID-19 diagnosis and reported for non-pregnant women ≤45 years, and for men ≤45 years, as points of reference.
Results: Among 6585 outpatients, 169 were pregnant at diagnosis. By 90-day follow-up, two pregnant women during the third trimester had lower extremity venous thrombosis, one deep and one superficial vein thrombosis. The cumulative incidence of thrombotic events was 1.20 % (95 % confidence interval [CI]: 0.0 to 2.84 %). Respective rates were 0.47 % (95 % CI: 0.14 % to 0.79 %) among non-pregnant women, and 0.49 % (95 % CI: 0.06 % to 0.91 %) among men ≤45 years. No non-thrombotic cardiovascular events occurred in pregnant women. The rates of cardiovascular events were 0.53 % (95 % CI: 0.18 to 0.87) among non-pregnant women, and 0.68 % (95 % CI: 0.18 to 1.18) in men aged ≤45 years.
Conclusions: Thrombotic and cardiovascular events are rare among outpatients with COVID-19. Although a higher event rate among outpatient pregnant women cannot be excluded, the absolute event rates are low and do not warrant population-wide cardiovascular interventions to optimize outcomes.
Keywords: COVID-19; Cardiovascular events; Outpatient; Pregnancy; Venous thromboembolism.
. 2024 May:237:209-215.
doi: 10.1016/j.thromres.2024.02.021. Epub 2024 Apr 6. Low absolute risk of thrombotic and cardiovascular events in outpatient pregnant women with COVID-19
Behnood Bikdeli[SUP] 1 [/SUP], Darsiya Krishnathasan[SUP] 2 [/SUP], Candrika D Khairani[SUP] 2 [/SUP], Antoine Bejjani[SUP] 2 [/SUP], Julia Davies[SUP] 2 [/SUP], Nicole Porio[SUP] 2 [/SUP], Anthony Tristani[SUP] 2 [/SUP], Andre Armero[SUP] 2 [/SUP], Ali A Assi[SUP] 3 [/SUP], Victor Nauffal[SUP] 4 [/SUP], Umberto Campia[SUP] 2 [/SUP], Zaid Almarzooq[SUP] 4 [/SUP], Eric Wei[SUP] 4 [/SUP], Marcos D Ortiz-Rios[SUP] 5 [/SUP], Valeria Zuluaga-Sánchez[SUP] 6 [/SUP], Aditya Achanta[SUP] 7 [/SUP], Sirus J Jesudasen[SUP] 8 [/SUP], Bruce Tiu[SUP] 6 [/SUP], Geno J Merli[SUP] 9 [/SUP], Orly Leiva[SUP] 5 [/SUP], John Fanikos[SUP] 10 [/SUP], Elvira Grandone[SUP] 11 [/SUP], Aditya Sharma[SUP] 12 [/SUP], Samantha Rizzo[SUP] 6 [/SUP], Mariana B Pfeferman[SUP] 6 [/SUP], Ruth B Morrison[SUP] 2 [/SUP], Alec Vishnevsky[SUP] 9 [/SUP], Judith Hsia[SUP] 13 [/SUP], Mark R Nehler[SUP] 14 [/SUP], James Welker[SUP] 15 [/SUP], Marc P Bonaca[SUP] 13 [/SUP], Brett Carroll[SUP] 16 [/SUP], Samuel Z Goldhaber[SUP] 2 [/SUP], Zhou Lan[SUP] 17 [/SUP], Gregory Piazza[SUP] 18 [/SUP]; CORONA-VTE-Network Investigators
Affiliations
- PMID: 38677791
- DOI: 10.1016/j.thromres.2024.02.021
Introduction: Pregnancy may contribute to an excess risk of thrombotic or cardiovascular events. COVID-19 increases the risk of these events, although the risk is relatively limited among outpatients. We sought to determine whether outpatient pregnant women with COVID-19 are at a high risk for cardiovascular or thrombotic events.
Materials & methods: We analyzed pregnant outpatients with COVID-19 from the multicenter CORONA-VTE-Network registry. The main study outcomes were a composite of adjudicated venous or arterial thrombotic events, and a composite of adjudicated cardiovascular events. Events were assessed 90 days after the COVID-19 diagnosis and reported for non-pregnant women ≤45 years, and for men ≤45 years, as points of reference.
Results: Among 6585 outpatients, 169 were pregnant at diagnosis. By 90-day follow-up, two pregnant women during the third trimester had lower extremity venous thrombosis, one deep and one superficial vein thrombosis. The cumulative incidence of thrombotic events was 1.20 % (95 % confidence interval [CI]: 0.0 to 2.84 %). Respective rates were 0.47 % (95 % CI: 0.14 % to 0.79 %) among non-pregnant women, and 0.49 % (95 % CI: 0.06 % to 0.91 %) among men ≤45 years. No non-thrombotic cardiovascular events occurred in pregnant women. The rates of cardiovascular events were 0.53 % (95 % CI: 0.18 to 0.87) among non-pregnant women, and 0.68 % (95 % CI: 0.18 to 1.18) in men aged ≤45 years.
Conclusions: Thrombotic and cardiovascular events are rare among outpatients with COVID-19. Although a higher event rate among outpatient pregnant women cannot be excluded, the absolute event rates are low and do not warrant population-wide cardiovascular interventions to optimize outcomes.
Keywords: COVID-19; Cardiovascular events; Outpatient; Pregnancy; Venous thromboembolism.