| 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 |
| Bleeding |
| Severity |
| Anticoagulant |
| Hospitalization |
| Mortality |
| 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 |
| URI: | http://hdl.handle.net/2115/87066 |
| 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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