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http://repo.knmu.edu.ua/handle/123456789/32628
Title: | Thrombotic and hemorrhagic complications of COVID-19 in adults hospitalized in high-income countries compared with those in adults hospitalized in low- and middle-income countries in an international registry |
Authors: | Gavrylov, Anatoliy Tieroshyn, Vadym Griffee, M.J. Bozza, P.T. Reyes, L.F. Zoufaly, A. Zucman, D. ISARIC Clinical Characterisation Group |
Keywords: | COVID-19 developing countries disseminated intravascular coagulation hemorrhage ischemic stroke SARS-CoV-2 thromboembolism thrombosis 2023а |
Issue Date: | 25-Jan-2023 |
Citation: | Thrombotic and hemorrhagic complications of COVID-19 in adults hospitalized in high-income countries compared with those in adults hospitalized in low- and middle-income countries in an international registry / M. J. Griffee, P. T. Bozza, L. F. Reyes [at al.] // Research and Practice in Thrombosis and Haemostasis. ─ 2023. ─ Vol. 7 (5). ─ P. 1─18. |
Abstract: | Background: COVID-19 has been associated with a broad range of thromboembolic, ischemic, and hemorrhagic complications (coagulopathy complications). Most studies have focused on patients with severe disease from high-income countries (HICs). Objectives: The main aims were to compare the frequency of coagulopathy complications in developing countries (low- and middle-income countries [LMICs]) with those in HICs, delineate the frequency across a range of treatment levels, and determine associations with in-hospital mortality. Methods: Adult patients enrolled in an observational, multinational registry, the International Severe Acute Respiratory and Emerging Infections COVID-19 study, between January 1, 2020, and September 15, 2021, met inclusion criteria, including admission to a hospital for laboratory-confirmed, acute COVID-19 and data on complications and survival. The advanced-treatment cohort received care, such as admission to the intensive care unit, mechanical ventilation, or inotropes or vasopressors; the basic-treatment cohort did not receive any of these interventions. Results: The study population included 495,682 patients from 52 countries, with 63% from LMICs and 85% in the basic treatment cohort. The frequency of coagulopathy complications was higher in HICs (0.76%-3.4%) than in LMICs (0.09%-1.22%). Complications were more frequent in the advanced-treatment cohort than in the basic-treatment cohort. Coagulopathy complications were associated with increased in-hospital mortality (odds ratio, 1.58; 95% CI, 1.52-1.64). The increased mortality associated with these complications was higher in LMICs (58.5%) than in HICs (35.4%). After controlling for coagulopathy complications, treatment intensity, and multiple other factors, the mortality was higher among patients in LMICs than among patients in HICs (odds ratio, 1.45; 95% CI, 1.39-1.51). Conclusion: In a large, international registry of patients hospitalized for COVID-19, coagulopathy complications were more frequent in HICs than in LMICs (developing countries). Increased mortality associated with coagulopathy complications was of a greater magnitude among patients in LMICs. Additional research is needed regarding timely diagnosis of and intervention for coagulation derangements associated with COVID-19, particularly for limited-resource settings. |
URI: | http://repo.knmu.edu.ua/handle/123456789/32628 |
Appears in Collections: | Наукові праці. Кафедра дитячих інфекційних хвороб |
Files in This Item:
File | Description | Size | Format | |
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Research and Practice in Thrombosis and Haemostasis.pdf | 3,3 MB | Adobe PDF | View/Open |
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