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

Nakamura, Junichi; Tsujino, Ichizo; Yachi, Sen et al.

Thrombosis journal, 2022, 20(1), 53

Permalink : https://hdl.handle.net/2115/87066

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https://doi.org/10.1186/s12959-022-00414-x     2

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アクセス権
metadata only access
URI
https://hdl.handle.net/2115/87066
タイトル
Incidence, risk factors, and clinical impact of major bleeding in hospitalized patients with COVID-19 : a sub-analysis of the CLOT-COVID Study
著者
Nakamura, Junichi ; Tsujino, Ichizo ; Yachi, Sen ; Takeyama, Makoto ; Nishimoto, Yuji ; Konno, Satoshi ; Yamamoto, Naoto ; Nakata, Hiroko ; Ikeda, Satoshi ; Umetsu, Michihisa ; Aikawa, Shizu ; Hayashi, Hiroya ; Satokawa, Hirono ; Okuno, Yoshinori ; Iwata, Eriko ; Ogihara, Yoshito ; Ikeda, Nobutaka ; Kondo, Akane ; Iwai, Takehisa ; Yamada, Norikazu ; Ogawa, Tomohiro ; Kobayashi, Takao ; Mo, Makoto ; Yamashita, Yugo
著者名
Nakamura, Junichi
e-Rad_Researcher
00344507
著者名
Tsujino, Ichizo
著者名
Yachi, Sen
著者名
Takeyama, Makoto
著者名
Nishimoto, Yuji
著者名
Konno, Satoshi
著者名
Yamamoto, Naoto
著者名
Nakata, Hiroko
著者名
Ikeda, Satoshi
著者名
Umetsu, Michihisa
著者名
Aikawa, Shizu
著者名
Hayashi, Hiroya
著者名
Satokawa, Hirono
著者名
Okuno, Yoshinori
著者名
Iwata, Eriko
著者名
Ogihara, Yoshito
著者名
Ikeda, Nobutaka
著者名
Kondo, Akane
著者名
Iwai, Takehisa
著者名
Yamada, Norikazu
著者名
Ogawa, Tomohiro
著者名
Kobayashi, Takao
著者名
Mo, Makoto
著者名
Yamashita, Yugo
言語
英語
キーワード
COVID-19
Bleeding
Severity
Anticoagulant
Hospitalization
Mortality
発行日
2022-09-20
出版者
BioMed Central
収録物名
Thrombosis journal
巻(号)
20(1)
ページ
53
抄録
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.
資源タイプ
学術雑誌論文
出版タイプ
Version of Record
PISSN
1477-9560
関連情報 (isIdenticalTo)
出版社版DOI
https://doi.org/10.1186/s12959-022-00414-x