Extrapulmonary manifestations of COVID-19

Nature Medicine, Journal Year: 2020, Volume and Issue: 26(7), P. 1017 - 1032

Published: July 1, 2020

Language: Английский

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COVID-19 and its implications for thrombosis and anticoagulation

Blood, Journal Year: 2020, Volume and Issue: 135(23), P. 2033 - 2040

Published: April 27, 2020

Language: Английский

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Epidemiology, clinical course, and outcomes of critically ill adults with COVID-19 in New York City: a prospective cohort study

The Lancet, Journal Year: 2020, Volume and Issue: 395(10239), P. 1763 - 1770

Published: May 20, 2020

Over 40 000 patients with COVID-19 have been hospitalised in New York City (NY, USA) as of April 28, 2020. Data on the epidemiology, clinical course, and outcomes critically ill this setting are needed.

Language: Английский

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Venous and arterial thromboembolic complications in COVID-19 patients admitted to an academic hospital in Milan, Italy

Thrombosis Research, Journal Year: 2020, Volume and Issue: 191, P. 9 - 14

Published: April 23, 2020

BackgroundFew data are available on the rate and characteristics of thromboembolic complications in hospitalized patients with COVID-19.MethodsWe studied consecutive symptomatic laboratory-proven COVID-19 admitted to a university hospital Milan, Italy (13.02.2020–10.04.2020). The primary outcome was any complication, including venous thromboembolism (VTE), ischemic stroke, acute coronary syndrome (ACS)/myocardial infarction (MI). Secondary overt disseminated intravascular coagulation (DIC).ResultsWe included 388 (median age 66 years, 68% men, 16% requiring intensive care [ICU]). Thromboprophylaxis used 100% ICU 75% those general ward. Thromboembolic events occurred 28 (7.7% closed cases; 95%CI 5.4%–11.0%), corresponding cumulative 21% (27.6% ICU, 6.6% ward). Half were diagnosed within 24 h admission. Forty-four underwent VTE imaging tests confirmed 16 (36%). Computed tomography pulmonary angiography (CTPA) performed 30 patients, 7.7% total, embolism 10 (33% CTPA). stroke ACS/MI 2.5% 1.1%, respectively. Overt DIC present 8 (2.2%) patients.ConclusionsThe high number arterial and, particular, admission positive among few tested suggest that there is an urgent need improve specific diagnostic strategies investigate efficacy safety thromboprophylaxis ambulatory patients.

Language: Английский

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Confirmation of the high cumulative incidence of thrombotic complications in critically ill ICU patients with COVID-19: An updated analysis

Thrombosis Research, Journal Year: 2020, Volume and Issue: 191, P. 148 - 150

Published: April 30, 2020

Language: Английский

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Severe Covid-19

New England Journal of Medicine, Journal Year: 2020, Volume and Issue: 383(25), P. 2451 - 2460

Published: May 15, 2020

Key Clinical Points Evaluation and Management of Severe Covid-19 Patients with severe coronavirus disease 2019 (Covid-19) may become critically ill acute respiratory distress syndrome that typ...

Language: Английский

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Incidence of venous thromboembolism in hospitalized patients with COVID‐19

Journal of Thrombosis and Haemostasis, Journal Year: 2020, Volume and Issue: 18(8), P. 1995 - 2002

Published: May 5, 2020

Coronavirus disease 2019 (COVID-19) can lead to systemic coagulation activation and thrombotic complications.To investigate the incidence of objectively confirmed venous thromboembolism (VTE) in hospitalized patients with COVID-19.Single-center cohort study 198 COVID-19.Seventy-five (38%) were admitted intensive care unit (ICU). At time data collection, 16 (8%) still 19% had died. During a median follow-up 7 days (IQR, 3-13), 39 (20%) diagnosed VTE whom 25 (13%) symptomatic VTE, despite routine thrombosis prophylaxis. The cumulative incidences at 7, 14 21 16% (95% CI, 10-22), 33% 23-43) 42% CI 30-54) respectively. For these 10% 5.8-16), 21% 14-30) 25% 16-36). appeared be associated death (adjusted HR, 2.4; 95% 1.02-5.5). was higher ICU (26% 17-37), 47% 34-58), 59% 42-72) days) than on wards (any 5.8% 1.4-15), 9.2% 2.6-21), (2.6-21) 14, days).The observed risk for COVID-19 is high, particularly patients, which should high level clinical suspicion low threshold diagnostic imaging DVT or PE. Future research focus optimal prophylactic strategies prevent potentially improve survival.

Language: Английский

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Endotheliopathy in COVID-19-associated coagulopathy: evidence from a single-centre, cross-sectional study

The Lancet Haematology, Journal Year: 2020, Volume and Issue: 7(8), P. e575 - e582

Published: June 30, 2020

Language: Английский

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Factors Associated With Death in Critically Ill Patients With Coronavirus Disease 2019 in the US

JAMA Internal Medicine, Journal Year: 2020, Volume and Issue: 180(11), P. 1436 - 1436

Published: July 15, 2020

Importance

The US is currently an epicenter of the coronavirus disease 2019 (COVID-19) pandemic, yet few national data are available on patient characteristics, treatment, and outcomes critical illness from COVID-19.

Objectives

To assess factors associated with death to examine interhospital variation in treatment for patients

Design, Setting, Participants

This multicenter cohort study assessed 2215 adults laboratory-confirmed COVID-19 who were admitted intensive care units (ICUs) at 65 hospitals across March 4 April 4, 2020.

Exposures

Patient-level data, including demographics, comorbidities, organ dysfunction, hospital number ICU beds.

Main Outcomes Measures

primary outcome was 28-day in-hospital mortality. Multilevel logistic regression used evaluate outcomes.

Results

A total (mean [SD] age, 60.5 [14.5] years; 1436 [64.8%] male; 1738 [78.5%] least 1 chronic comorbidity) included study. At 28 days after admission, 784 (35.4%) had died, 824 (37.2%) discharged, 607 (27.4%) remained hospitalized. end follow-up (median, 16 days; interquartile range, 8-28 days), 875 (39.5%) 1203 (54.3%) 137 (6.2%) Factors independently older age (≥80 vs <40 years age: odds ratio [OR], 11.15; 95% CI, 6.19-20.06), male sex (OR, 1.50; 1.19-1.90), higher body mass index (≥40 <25: OR, 1.51; 1.01-2.25), coronary artery 1.47; 1.07-2.02), active cancer 2.15; 1.35-3.43), presence hypoxemia (Pao₂:Fio₂<100 ≥300 mm Hg: 2.94; 2.11-4.08), liver dysfunction (liver Sequential Organ Failure Assessment score 2-4 0: 2.61; 1.30–5.25), kidney (renal 2.43; 1.46–4.05) admission. Patients fewer beds a risk (<50 ≥100 beds: 3.28; 2.16-4.99). Hospitals varied considerably risk-adjusted proportion died (range, 6.6%-80.8%) percentage received hydroxychloroquine, tocilizumab, other treatments supportive therapies.

Conclusions Relevance

identified demographic, clinical, hospital-level that may be critically ill can facilitate identification medications therapies improve

Language: Английский

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Risk of Ischemic Stroke in Patients With Coronavirus Disease 2019 (COVID-19) vs Patients With Influenza

JAMA Neurology, Journal Year: 2020, Volume and Issue: 77(11), P. 1366 - 1366

Published: July 2, 2020

Importance

It is uncertain whether coronavirus disease 2019 (COVID-19) associated with a higher risk of ischemic stroke than would be expected from viral respiratory infection.

Objective

To compare the rate between patients COVID-19 and influenza, illness previously stroke.

Design, Setting, Participants

This retrospective cohort study was conducted at 2 academic hospitals in New York City, York, included adult emergency department visits or hospitalizations March 4, 2020, through May 2, 2020. The comparison adults influenza A/B January 1, 2016, 31, 2018 (spanning moderate severe seasons).

Exposures

infection confirmed by evidence acute syndrome nasopharynx polymerase chain reaction laboratory-confirmed A/B.

Main Outcomes Measures

A panel neurologists adjudicated primary outcome its clinical characteristics, mechanisms, outcomes. We used logistic regression to proportion vs among influenza.

Results

Among 1916 COVID-19, 31 (1.6%; 95% CI, 1.1%-2.3%) had an median age 69 years (interquartile range, 66-78 years); 18 (58%) were men. Stroke reason for hospital presentation 8 cases (26%). In comparison, 3 1486 (0.2%; 0.0%-0.6%) After adjustment age, sex, race, likelihood (odds ratio, 7.6; 2.3-25.2). association persisted across sensitivity analyses adjusting vascular factors, symptomatology, intensive care unit admission.

Conclusions Relevance

this City hospitals, approximately 1.6% who visited hospitalized experienced stroke, compared Additional studies are needed confirm these findings investigate possible thrombotic mechanisms COVID-19.

Language: Английский

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