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Incidence, risk factors, and clinical impact of major bleeding in hospitalized patients with COVID-19 : a sub-analysis of the CLOT-COVID Study

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Title: Incidence, risk factors, and clinical impact of major bleeding in hospitalized patients with COVID-19 : a sub-analysis of the CLOT-COVID Study
Authors: Nakamura, Junichi Browse this author
Tsujino, Ichizo Browse this author →KAKEN DB
Yachi, Sen Browse this author
Takeyama, Makoto Browse this author
Nishimoto, Yuji Browse this author
Konno, Satoshi Browse this author
Yamamoto, Naoto Browse this author
Nakata, Hiroko Browse this author
Ikeda, Satoshi Browse this author
Umetsu, Michihisa Browse this author
Aikawa, Shizu Browse this author
Hayashi, Hiroya Browse this author
Satokawa, Hirono Browse this author
Okuno, Yoshinori Browse this author
Iwata, Eriko Browse this author
Ogihara, Yoshito Browse this author
Ikeda, Nobutaka Browse this author
Kondo, Akane Browse this author
Iwai, Takehisa Browse this author
Yamada, Norikazu Browse this author
Ogawa, Tomohiro Browse this author
Kobayashi, Takao Browse this author
Mo, Makoto Browse this author
Yamashita, Yugo Browse this author
Keywords: COVID-19
Issue Date: 20-Sep-2022
Publisher: BioMed Central
Journal Title: Thrombosis journal
Volume: 20
Issue: 1
Start Page: 53
Publisher DOI: 10.1186/s12959-022-00414-x
Abstract: Background The coronavirus disease 2019 (COVID-19) causes extensive coagulopathy and a potential benefit of anticoagulation therapy has been documented for prevention of thromboembolic events. Bleeding events has also been reported as a notable complication; whereas, the incidence, risks, and clinical impact of bleeding remain unclear. Method The CLOT-COVID Study was a nationwide, retrospective, multicenter cohort study on consecutive hospitalized patients with COVID-19 in Japan between April 2021 and September 2021. In this sub-analysis, we compared the characteristics of patients with and without major bleeding; moreover, we examined the risk factors for and clinical impact of bleeding events. Results Among 2882 patients with COVID-19, 57 (2.0%) had major bleeding. The incidence of major bleeding increased with COVID-19 severity as follows: 0.5%, 2.3%, and 12.3% in patients with mild, moderate, and severe COVID-19, respectively. COVID-19 severity, history of major bleeding, and anticoagulant type/dose were independently and additively associated with the bleeding incidence. Compared with patients without major bleeding, those with major bleeding exhibited a longer duration of hospitalization (9 [6-14] vs 28 [19-43] days, P < 0.001) and higher mortality during hospitalization (4.9% vs. 35.1%, P < 0.001). Conclusions In the real-world clinical practice, the incidence of major bleeding was not uncommon, especially in patients with severe COVID-19. Independent risk factors for major bleeding included history of major bleeding, COVID-19 severity, and anticoagulant use, which could be associated with poor clinical outcomes including higher mortality. Precise recognition of the risks for bleeding may be helpful for an optimal use of anticoagulants and for better outcomes in patients with COVID-19.
Type: article
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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