TY - JOUR
T1 - SARS-CoV-2 Positivity in Ambulatory Symptomatic Patients Is Not Associated With Increased Venous or Arterial Thrombotic Events in the Subsequent 30 Days
AU - Thoppil, Joby J.
AU - Courtney, D. Mark
AU - McDonald, Samuel
AU - Kabrhel, Christopher
AU - Nordenholz, Kristen E.
AU - Camargo, Carlos A.
AU - Kline, Jeffrey A.
N1 - Publisher Copyright:
© 2022 Elsevier Ltd
PY - 2022/6
Y1 - 2022/6
N2 - Background: COVID-19 has been associated with increased risk of thromboembolism in critically ill patients. Objective: We sought to examine the association of SARS-CoV-2 test positivity and subsequent acute vascular thrombosis, including venous thromboembolism (VTE) or arterial thrombosis (AT), in a large nationwide registry of emergency department (ED) patients tested with a nucleic acid test for suspected SARS-CoV-2. Methods: The RECOVER (Registry of Potential COVID-19 in Emergency Care) registry includes 155 EDs across the United States. We performed a retrospective cohort study to produce odds ratios (ORs) for COVID-19–positive vs. COVID-19–negative status as a predictor of 30-day VTE or AT, adjusting for age, sex, active cancer, intubation, hospital length of stay, and intensive care unit (ICU) care. Results: Comparing 14,056 COVID-19–positive patients with 12,995 COVID-19–negative patients, the overall 30-day prevalence of VTE events was 1.4% vs. 1.3%, respectively (p = 0.44, χ2). Multivariable analysis identified that testing positive for SARS-CoV-2 status was negatively associated with both VTE (OR 0.76; 95% confidence interval [CI] 0.61–0.94) and AT (OR 0.51; 95% CI 0.32–0.80), whereas intubation, ICU care, and age 50 years or older were positively associated with both VTE and AT. Conclusions: In contrast to other reports, results from this large, hetereogenous national sample of ED patients tested for SARS-CoV-2, showed no association between vascular thrombosis and COVID-19 test positivity.
AB - Background: COVID-19 has been associated with increased risk of thromboembolism in critically ill patients. Objective: We sought to examine the association of SARS-CoV-2 test positivity and subsequent acute vascular thrombosis, including venous thromboembolism (VTE) or arterial thrombosis (AT), in a large nationwide registry of emergency department (ED) patients tested with a nucleic acid test for suspected SARS-CoV-2. Methods: The RECOVER (Registry of Potential COVID-19 in Emergency Care) registry includes 155 EDs across the United States. We performed a retrospective cohort study to produce odds ratios (ORs) for COVID-19–positive vs. COVID-19–negative status as a predictor of 30-day VTE or AT, adjusting for age, sex, active cancer, intubation, hospital length of stay, and intensive care unit (ICU) care. Results: Comparing 14,056 COVID-19–positive patients with 12,995 COVID-19–negative patients, the overall 30-day prevalence of VTE events was 1.4% vs. 1.3%, respectively (p = 0.44, χ2). Multivariable analysis identified that testing positive for SARS-CoV-2 status was negatively associated with both VTE (OR 0.76; 95% confidence interval [CI] 0.61–0.94) and AT (OR 0.51; 95% CI 0.32–0.80), whereas intubation, ICU care, and age 50 years or older were positively associated with both VTE and AT. Conclusions: In contrast to other reports, results from this large, hetereogenous national sample of ED patients tested for SARS-CoV-2, showed no association between vascular thrombosis and COVID-19 test positivity.
KW - COVID-19
KW - SARS-CoV-2
KW - critical care
KW - thromboembolism
KW - thrombosis
KW - venous
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U2 - 10.1016/j.jemermed.2021.12.020
DO - 10.1016/j.jemermed.2021.12.020
M3 - Article
C2 - 35177286
AN - SCOPUS:85124584181
SN - 0736-4679
VL - 62
SP - 716
EP - 724
JO - Journal of Emergency Medicine
JF - Journal of Emergency Medicine
IS - 6
ER -