COVID-19 is associated with higher risk of venous thrombosis, but not arterial thrombosis, compared with influenza: Insights from a large US cohort

Ward, Andrew; Sarraju, Ashish; Lee, Dong-Hyun; Bhasin, Kanchan; Gad, Sanchit; Beetel, Robert; Chang, Stella; Bonafede, Mac; Rodríguez, Fátima; Dash, Rajesh

doi:10.1101/2021.10.15.21264137

Cited by 8 publications

(11 citation statements)

References 20 publications

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“…Importantly, as exclusion criterion, in our series there were no macroscopic evidence of peripheral thrombosis, thus, this further supports the in situ formation of the arterial thrombi we found. Anyway, in a large retrospective US cohort, the risk of arterial thrombosis in COVID-19 was not higher than that reported in influenza [47] , even if this comparison is still controversial.…”

Section: Discussionmentioning

confidence: 69%

Clinical, laboratory and immunohistochemical characterization of in situ pulmonary arterial thrombosis in fatal COVID-19

Quartuccio¹,

Sonaglia²,

Casarotto³

et al. 2022

Thrombosis Research

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Section: Discussionmentioning

confidence: 69%

Clinical, laboratory and immunohistochemical characterization of in situ pulmonary arterial thrombosis in fatal COVID-19

Quartuccio¹,

Sonaglia²,

Casarotto³

et al. 2022

Thrombosis Research

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“…In a retrospective cohort, the unadjusted incidence of ATE (AIS + AMI) was more than double in COVID-19 than in influenza (7.1 vs. 3.0%). 48 However, after propensity score matching there was no difference between the two groups (hazard ratio 1.02, 95% CI, 0.95–1.10). 48 Nemetski et al found a slightly higher incidence of ATE in patients with COVID-19 ( n = 4,451) when compared with patients hospitalized for influenza ( n = 468) or non-COVID-19 illness ( n = 40,359) and, notably, none of the influenza patients experienced an ATE.…”

Section: Discussionmentioning

confidence: 97%

“…48 However, after propensity score matching there was no difference between the two groups (hazard ratio 1.02, 95% CI, 0.95–1.10). 48 Nemetski et al found a slightly higher incidence of ATE in patients with COVID-19 ( n = 4,451) when compared with patients hospitalized for influenza ( n = 468) or non-COVID-19 illness ( n = 40,359) and, notably, none of the influenza patients experienced an ATE. 32 However, the study was retrospective and the real incidence of ATE in the non-COVID-19 population could have been underestimated.…”

Section: Discussionmentioning

confidence: 97%

Arterial Thrombotic Events in Hospitalized COVID-19 Patients: A Short Review and Meta-Analysis

Candeloro

Schulman

2022

Semin Thromb Hemost

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It is well established that the risk of venous thromboembolism is high in coronavirus disease 19 (COVID-19). The frequency of arterial thromboembolic events (ATEs) in hospitalized patients with COVID-19 is unclear, as is the magnitude of these events in comparison with other infections. We searched MEDLINE from February 2020 to February 2022 for prospective or retrospective cohort studies and randomized clinical trials that reported the number of acute myocardial infarction (AMI), acute ischemic stroke (AIS), acute limb ischemia (ALI), or other ATE as defined by the original authors in hospitalized patients with COVID-19. The pooled frequencies were calculated through meta-analysis using random effects model with logit transformation and presented with relative 95% prediction intervals (95% PI). We retrieved a total of 4,547 studies, 36 of which (28 retrospective cohorts, five prospective cohorts and three randomized trials) were finally included in our analysis. The resulting cohort counted 100,949 patients, 2,641 (2.6%) of whom experienced ATE. The pooled ATE frequency was 2.0% (95% PI, 0.4–9.6%). The pooled ATE frequency for AMI, AIS, ALI, and other ATE was 0.8% (95% PI, 0.1–8.1%), 0.9% (95% PI, 0.3–2.9%), 0.2% (95% PI, 0.0–4.2%), and 0.5% (95% PI, 0.1–3.0%), respectively. In comparison with the ATE incidence reported in three studies on non-COVID viral pneumonia, we did not detect a significant difference from the results in our analysis. In conclusion, we found a non-negligible proportion of ATE in patients hospitalized for COVID-19. Our results are similar to those found in hospitalized patients with influenza or with non-COVID viral pneumonia.

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“…The endothelial dysfunction should explain why individuals with COVID-19 are at high risk for venous and arterial thrombotic events [150], particularly the patients with a severe course of disease [151]. The risk is visible when comparing critically ill patients with COVID-19 and non-COVID-19 respiratory diseases [152].…”

Section: Covid-19 and The Risk Of Thrombotic Events: The Potential Ro...mentioning

confidence: 99%

Antithrombotic and antiplatelet effects of plant-derived compounds: a great utility potential for primary, secondary, and tertiary care in the framework of 3P medicine

et al. 2022

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Thromboembolism is the third leading vascular disease, with a high annual incidence of 1 to 2 cases per 1000 individuals within the general population. The broader term venous thromboembolism generally refers to deep vein thrombosis, pulmonary embolism, and/or a combination of both. Therefore, thromboembolism can affect both – the central and peripheral veins. Arterial thromboembolism causes systemic ischemia by disturbing blood flow and oxygen supply to organs, tissues, and cells causing, therefore, apoptosis and/or necrosis in the affected tissues. Currently applied antithrombotic drugs used, e.g. to protect affected individuals against ischemic stroke, demonstrate significant limitations. For example, platelet inhibitors possess only moderate efficacy. On the other hand, thrombolytics and anticoagulants significantly increase hemorrhage. Contextually, new approaches are extensively under consideration to develop next-generation antithrombotics with improved efficacy and more personalized and targeted application. To this end, phytochemicals show potent antithrombotic efficacy demonstrated in numerous in vitro, ex vivo, and in vivo models as well as in clinical evaluations conducted on healthy individuals and persons at high risk of thrombotic events, such as pregnant women (primary care), cancer, and COVID-19-affected patients (secondary and tertiary care). Here, we hypothesized that specific antithrombotic and antiplatelet effects of plant-derived compounds might be of great clinical utility in primary, secondary, and tertiary care. To increase the efficacy, precise patient stratification based on predictive diagnostics is essential for targeted protection and treatments tailored to the person in the framework of 3P medicine. Contextually, this paper aims at critical review toward the involvement of specific classes of phytochemicals in antiplatelet and anticoagulation adapted to clinical needs. The paper exemplifies selected plant-derived drugs, plant extracts, and whole plant foods/herbs demonstrating their specific antithrombotic, antiplatelet, and fibrinolytic activities relevant for primary, secondary, and tertiary care. One of the examples considered is antithrombotic and antiplatelet protection specifically relevant for COVID-19-affected patient groups.

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COVID-19 is associated with higher risk of venous thrombosis, but not arterial thrombosis, compared with influenza: Insights from a large US cohort

Cited by 8 publications

References 20 publications

Clinical, laboratory and immunohistochemical characterization of in situ pulmonary arterial thrombosis in fatal COVID-19

Clinical, laboratory and immunohistochemical characterization of in situ pulmonary arterial thrombosis in fatal COVID-19

Arterial Thrombotic Events in Hospitalized COVID-19 Patients: A Short Review and Meta-Analysis

Antithrombotic and antiplatelet effects of plant-derived compounds: a great utility potential for primary, secondary, and tertiary care in the framework of 3P medicine

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