Abstract
Background
Coagulation dysfunction represents a serious complication in patients during the COVID-19 infection, while fulminant thrombotic complications emerge as critical issues in individuals with severe COVID-19. In addition to a severe clinical presentation, comorbidities and age significantly contribute to the development of thrombotic complications in this disease. However, there is very little data on association of congenital thrombophilia and thrombotic events in the setting of COVID-19. Our study aimed to evaluate the risk of COVID-19 associated thrombosis in patients with congenital thrombophilia.
Methods
This prospective, case-control study included patients with confirmed COVID-19 infection, followed 6 months post-confirmation. The final outcome was a symptomatic thrombotic event. In total, 90 COVID-19 patients, 30 with known congenital thrombophilia and 60 patients without thrombophilia within the period July 2020–November 2021, were included in the study. Evaluation of hemostatic parameters including FVIII activity and D-dimer was performed for all patients at 1 month, 3 months and 6 months post-COVID-19 diagnosis.
Results
Symptomatic thrombotic events were observed in 7 out of 30 (23 %) COVID-19 patients with thrombophilia, and 12 out of 60 (20 %) without thrombophilia, P = 0.715. In addition, the two patient groups had comparable localization of thrombotic events, time to thrombotic event, effect of antithrombotic treatment and changes in FVIII activity, while D-dimer level were significantly increased in patients without thrombophilia.
Conclusion
Our findings suggest that patients with congenital thrombophilia, irrespective of their age, a mild clinical picture and absence of comorbidities, should receive anticoagulant prophylaxis, adjusted based on the specific genetic defect.
【저자키워드】 Venous Thromboembolism, Computed tomography, body mass index, Pulmonary embolism, Deep venous thrombosis, Antithrombin, Direct oral anticoagulant, Anticoagulants, factor VIII, Odds ratio, low molecular weight heparin, vitamin K antagonist, BMIbody mass index, LMWHlow molecular weight heparin, COVIDCorona Virus Disease, Corona Virus Disease, VTEVenous Thromboembolism, ATAntithrombin, FV LeidenFactor V Leiden, Factor V Leiden, FII G20210AProthrombin mutation, Prothrombin mutation, DVTDeep Venous Thrombosis, PEPulmonary Embolism, PCR/RFLPpolymerase chain reaction/restriction fragment length polymorphism, polymerase chain reaction/restriction fragment length polymorphism, HBSHeparin Binding Site, Heparin Binding Site, OROdds Ratio, ACAnticoagulants, VKAVitamin K antagonist, DOACDirect Oral Anticoagulant, FVIIIFactor VIII, FEUFibrinogen Equivalent, Fibrinogen Equivalent, UTUnusual Thrombosis, Unusual Thrombosis, CTComputed Tomography, 【초록키워드】 COVID-19, Treatment, thrombosis, severe COVID-19, Comorbidities, Diagnosis, Comorbidity, D-dimer, outcome, Prophylaxis, COVID-19 infection, clinical picture, symptomatic, Patient, Mild, age, disease, Critical, Thrombotic events, COVID-19 patients, case-control study, association, Anticoagulant, Antithrombotic, D-dimer level, COVID-19 patient, dysfunction, individual, thrombotic, Confirmed COVID-19 infection, Final, genetic defect, parameter, FVIII, risk of COVID-19, thrombotic event, thrombotic complication, serious complication, significantly increased, Result, evaluate, significantly, addition, patient group, was performed, adjusted, changes in, contribute, absence, comparable, receive, 【제목키워드】 Infection, risk, COVID, Patient,