article Open Access (bronze) EN 2021-05-20

Postdischarge thromboembolic outcomes and mortality of hospitalized patients with COVID-19: the CORE-19 registry

Dimitrios Giannis, Steven L. Allen, James Tsang, Sarah Flint, Tamir Pinhasov, Stephanie Williams, Gary Tan, Richa Thakur, Christian Leung, Matthew Snyder, Chirag Bhatia, David Garrett, Christina Cotte, Shelby Isaacs, Emma Gugerty, Anne Davidson, Galina Marder, Austin Schnitzer, Bradley Goldberg, Thomas McGinn, Karina W. Davidson, Matthew A. Barish, Michael Qiu, Meng Zhang, Mark Goldin, Miltiadis Matsagkas, Eleni Αrnaoutoglou, Alex C. Spyropoulos

Blood, Vol. 137, Issue 20, pp. 2838–2847 (2021)

Northwell Health, Feinstein Institute for Medical Research, University of Thessaly, Health Innovations (United States), Donald & Barbara Zucker School of Medicine at Hofstra/Northwell, Institute of Molecular Medicine

DOI: 10.1182/blood.2020010529 PMID: 33824972

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Abstract

Thromboembolic events, including venous thromboembolism (VTE) and arterial thromboembolism (ATE), and mortality from subclinical thrombotic events occur frequently in coronavirus disease 2019 (COVID-19) inpatients. Whether the risk extends postdischarge has been controversial. Our prospective registry included consecutive patients with COVID-19 hospitalized within our multihospital system from 1 March to 31 May 2020. We captured demographics, comorbidities, laboratory parameters, medications, postdischarge thromboprophylaxis, and 90-day outcomes. Data from electronic health records, health informatics exchange, radiology database, and telephonic follow-up were merged. Primary outcome was a composite of adjudicated VTE, ATE, and all-cause mortality (ACM). Principal safety outcome was major bleeding (MB). Among 4906 patients (53.7% male), mean age was 61.7 years. Comorbidities included hypertension (38.6%), diabetes (25.1%), obesity (18.9%), and cancer history (13.1%). Postdischarge thromboprophylaxis was prescribed in 13.2%. VTE rate was 1.55%; ATE, 1.71%; ΑCM, 4.83%; and MB, 1.73%. Composite primary outcome rate was 7.13% and significantly associated with advanced age (odds ratio [OR], 3.66; 95% CI, 2.84-4.71), prior VTE (OR, 2.99; 95% CI, 2.00-4.47), intensive care unit (ICU) stay (OR, 2.22; 95% CI, 1.78-2.93), chronic kidney disease (CKD; OR, 2.10; 95% CI, 1.47-3.0), peripheral arterial disease (OR, 2.04; 95% CI, 1.10-3.80), carotid occlusive disease (OR, 2.02; 95% CI, 1.30-3.14), IMPROVE-DD VTE score ≥4 (OR, 1.51; 95% CI, 1.06-2.14), and coronary artery disease (OR, 1.50; 95% CI, 1.04-2.17). Postdischarge anticoagulation was significantly associated with reduction in primary outcome (OR, 0.54; 95% CI, 0.47-0.81). Postdischarge VTE, ATE, and ACM occurred frequently after COVID-19 hospitalization. Advanced age, cardiovascular risk factors, CKD, IMPROVE-DD VTE score ≥4, and ICU stay increased risk. Postdischarge anticoagulation reduced risk by 46%.

Topics

Venous Thromboembolism Diagnosis and Management 1.00 COVID-19 Clinical Research Studies 1.00 COVID-19 and healthcare impacts 1.00

Field: Medicine · Subfield: Internal Medicine

Keywords

Medicine,Internal medicine,Kidney disease,Odds ratio,Comorbidity,Intensive care unit,Diabetes mellitus

MeSH Terms

COVID-19COVID-19COVID-19SARS-CoV-2SARS-CoV-2SARS-CoV-2AgedAged

UN Sustainable Development Goals

Good health and well-being (0.88)

All Available Versions

PDF Landing page — Blood publishedVersion
Landing page — PubMed publishedVersion
Landing page — PubMed Central submittedVersion
Landing page — University of Thessaly Institutional Repository (University of Thessaly) submittedVersion

Citations by Year

2026	2025	2024	2023	2022	2021
3	15	22	48	67	36

APA

Dimitrios Giannis, Steven L. Allen, James Tsang, Sarah Flint, Tamir Pinhasov, Stephanie Williams, Gary Tan, Richa Thakur, Christian Leung, Matthew Snyder, Chirag Bhatia, David Garrett, Christina Cotte, Shelby Isaacs, Emma Gugerty, Anne Davidson, Galina Marder, Austin Schnitzer, Bradley Goldberg, Thomas McGinn, Karina W. Davidson, Matthew A. Barish, Michael Qiu, Meng Zhang, Mark Goldin, Miltiadis Matsagkas, Eleni Αrnaoutoglou, Alex C. Spyropoulos (2021). Postdischarge thromboembolic outcomes and mortality of hospitalized patients with COVID-19: the CORE-19 registry. Blood, 137(20), 2838–2847. https://doi.org/10.1182/blood.2020010529

MLA

Dimitrios Giannis, et al. "Postdischarge thromboembolic outcomes and mortality of hospitalized patients with COVID-19: the CORE-19 registry." Blood, vol. 137, no. 20, 2021, pp. 2838–2847. https://doi.org/10.1182/blood.2020010529

Chicago

Dimitrios Giannis, Steven L. Allen, James Tsang, Sarah Flint, Tamir Pinhasov, Stephanie Williams, Gary Tan, Richa Thakur, Christian Leung, Matthew Snyder, Chirag Bhatia, David Garrett, Christina Cotte, Shelby Isaacs, Emma Gugerty, Anne Davidson, Galina Marder, Austin Schnitzer, Bradley Goldberg, Thomas McGinn, Karina W. Davidson, Matthew A. Barish, Michael Qiu, Meng Zhang, Mark Goldin, Miltiadis Matsagkas, Eleni Αrnaoutoglou, Alex C. Spyropoulos. "Postdischarge thromboembolic outcomes and mortality of hospitalized patients with COVID-19: the CORE-19 registry." Blood 137, no. 20 (2021): 2838–2847. https://doi.org/10.1182/blood.2020010529

BibTeX

@article{giannis2021,
  title = { Postdischarge thromboembolic outcomes and mortality of hospitalized patients with COVID-19: the CORE-19 registry },
  author = { Dimitrios Giannis and Steven L. Allen and James Tsang and Sarah Flint and Tamir Pinhasov and Stephanie Williams and Gary Tan and Richa Thakur and Christian Leung and Matthew Snyder and Chirag Bhatia and David Garrett and Christina Cotte and Shelby Isaacs and Emma Gugerty and Anne Davidson and Galina Marder and Austin Schnitzer and Bradley Goldberg and Thomas McGinn and Karina W. Davidson and Matthew A. Barish and Michael Qiu and Meng Zhang and Mark Goldin and Miltiadis Matsagkas and Eleni Αrnaoutoglou and Alex C. Spyropoulos },
  journal = { Blood },
  year = { 2021 },
  volume = { 137 },
  number = { 20 },
  pages = { 2838--2847 },
  doi = { 10.1182/blood.2020010529 }
}

RIS

TY  - JOUR
TI  - Postdischarge thromboembolic outcomes and mortality of hospitalized patients with COVID-19: the CORE-19 registry
AU  - Dimitrios Giannis
AU  - Steven L. Allen
AU  - James Tsang
AU  - Sarah Flint
AU  - Tamir Pinhasov
AU  - Stephanie Williams
AU  - Gary Tan
AU  - Richa Thakur
AU  - Christian Leung
AU  - Matthew Snyder
AU  - Chirag Bhatia
AU  - David Garrett
AU  - Christina Cotte
AU  - Shelby Isaacs
AU  - Emma Gugerty
AU  - Anne Davidson
AU  - Galina Marder
AU  - Austin Schnitzer
AU  - Bradley Goldberg
AU  - Thomas McGinn
AU  - Karina W. Davidson
AU  - Matthew A. Barish
AU  - Michael Qiu
AU  - Meng Zhang
AU  - Mark Goldin
AU  - Miltiadis Matsagkas
AU  - Eleni Αrnaoutoglou
AU  - Alex C. Spyropoulos
JO  - Blood
PY  - 2021
VL  - 137
IS  - 20
SP  - 2838
EP  - 2847
DO  - 10.1182/blood.2020010529
ER  -

191

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33.26

FWCI

100%

Normalized Pctile

References

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