Ho, F. K., Man, K. K.S., Toshner, M., Church, C., Celis-Morales, C. , Wong, I. C.K., Berry, C. , Sattar, N. and Pell, J. P. (2021) Thromboembolic risk in hospitalised and non-hospitalised Covid-19 patients: a self-controlled case series analysis of a nation-wide cohort. Mayo Clinic Proceedings, 96(10), pp. 2587-2597. (doi: 10.1016/j.mayocp.2021.07.002) (PMID:34607634) (PMCID:PMC8282478)
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Abstract
Objective: An unexpectedly large number of people infected with Covid-19 had experienced a thrombotic event. This study aims to assess the associations between Covid-19 infection and thromboembolism including myocardial infarction (MI), ischaemic stroke, deep-vein thrombosis (DVT), and pulmonary embolism (PE). Patients and Methods: A self-controlled case-series study was conducted covering the whole of Scotland’s general population. The study population comprised individuals with confirmed (positive test) Covid-19 and at least one thromboembolic event between March 2018 and October 2020. Their incidence rates during the risk interval (5 days before to 56 days after the positive test) and the control interval (the remaining periods) were compared intra-personally. Results: Across Scotland, 1,449 individuals tested positive for Covid-19 and experienced a thromboembolic event. The risk of thromboembolism was significantly elevated over the whole risk period but highest in the 7 days following the positive test (IRR 12.01, 95% CI 9.91-14.56) in all included individuals. The association was also present in individuals not originally hospitalised for Covid-19 (IRR 4.07, 95% CI 2.83-5.85). Risk of MI, stroke, PE and DVT were all significantly higher in the week following a positive test. The risk of PE and DVT was particularly high and remained significantly elevated even 56 days following the test. Conclusion: Confirmed Covid-19 infection was associated with early elevations in risk with MI, ischaemic stroke, and substantially stronger and prolonged elevations with DVT and PE both in hospital and community settings. Clinicians should consider thromboembolism, especially PE, among people with Covid-19 in the community.
Item Type: | Articles |
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Keywords: | Covid-19, thromboembolism, stroke. |
Status: | Published |
Refereed: | Yes |
Glasgow Author(s) Enlighten ID: | Ho, Dr Frederick and Celis, Dr Carlos and Pell, Professor Jill and Sattar, Professor Naveed and Church, Dr Colin and Berry, Professor Colin |
Authors: | Ho, F. K., Man, K. K.S., Toshner, M., Church, C., Celis-Morales, C., Wong, I. C.K., Berry, C., Sattar, N., and Pell, J. P. |
College/School: | College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health |
Journal Name: | Mayo Clinic Proceedings |
Publisher: | Elsevier |
ISSN: | 0025-6196 |
ISSN (Online): | 1942-5546 |
Published Online: | 16 July 2021 |
Copyright Holders: | Copyright © 2021 Mayo Foundation for Medical Education and Research |
First Published: | First published in Mayo Clinic Proceedings 96(10): 2587-2597 |
Publisher Policy: | Reproduced under a Creative Commons License |
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