Comparison of Thrombotic Events and Mortality in Patients with Community-Acquired Pneumonia and COVID-19: A Multicenter Observational Study

Published on
Journal: Thrombosis and haemostasis
[저자] Roberto Cangemi, Camilla Calvieri, Marco Falcone, Francesco Cipollone, Giancarlo Ceccarelli, Pasquale Pignatelli, Damiano D'Ardes, Matteo Pirro, Francesco Alessandri, Miriam Lichtner, Gabriella D'Ettorre, Alessandra Oliva, Raissa Aronica, Monica Rocco, Mario Venditti, Giulio Francesco Romiti, Giusy Tiseo, Gloria Taliani, Francesco Menichetti, Francesco Pugliese, Claudio Maria Mastroianni, Francesco Violi
[Category] COVID19(2023년),
Pubmed URL    [DOI] 10.1055/a-1692-9939    
[Article Type] Clinical Trial
[Source] pubmed

Background: It is still unclear if patients with community-acquired pneumonia (CAP) and coronavirus disease 2019 (COVID-19) have different rate, typology, and impact of thrombosis on survival.
Methods: In this multicenter observational cohort study, 1,138 patients, hospitalized for CAP ( n = 559) or COVID-19 ( n = 579) from seven clinical centers in Italy, were included in the study. Consecutive adult patients (age ≥ 18 years) with confirmed COVID-19-related pneumonia, with or without mechanical ventilation, hospitalized from March 1, 2020 to April 30, 2020, were enrolled. COVID-19 was diagnosed based on the World Health Organization interim guidance. Patients were followed-up until discharge or in-hospital death, registering the occurrence of thrombotic events including ischemic/embolic events.
Results: During the in-hospital stay, 11.4% of CAP and 15.5% of COVID-19 patients experienced thrombotic events ( p = 0.046). In CAP patients all the events were arterial thromboses, while in COVID-19 patients 8.3% were venous and 7.2% arterial thromboses.During the in-hospital follow-up, 3% of CAP patients and 17% of COVID-19 patients died ( p < 0.001). The highest mortality rate was found among COVID-19 patients with thrombotic events (47.6 vs. 13.4% in thrombotic-event-free patients; p < 0.001). In CAP, 13.8% of patients experiencing thrombotic events died versus 1.8% of thrombotic event-free ones ( p < 0.001). A multivariable Cox-regression analysis confirmed a higher risk of death in COVID-19 patients with thrombotic events (hazard ratio: 2.1; 95% confidence interval: 1.4-3.3; p < 0.001).
Conclusion: Compared with CAP, COVID-19 is characterized by a higher burden of thrombotic events, different thrombosis typology and higher risk of thrombosis-related in-hospital mortality.

All Keywords