Comparison of thrombotic and clinical outcomes in SARS-CoV-2-pneumonia versus other viral pneumonia in an urban academic medical center

• Published in: Heart & lung 2023-09, Vol.61, p.153-157
• Main Authors: Goldberg, Rachel, Ye, William, Johns, Kevin, Mucksavage, Jeffrey J., Dhandapani, Shvetha, Quigley, John G., Shapiro, Nancy L., Benken, Scott T., Wenzler, Eric, Kim, Keri S.
• Format: Article
• Language: English
• Subjects: Academic Medical Centers; Adult; COVID-19 - epidemiology; Healthy disparity; Humans; Influenza A Virus, H1N1 Subtype; Influenza A Virus, H3N2 Subtype; Pandemic; Pneumonia; Pneumonia, Viral - diagnosis; Pneumonia, Viral - epidemiology; Pneumonia, Viral - therapy; Retrospective Studies; SARS-CoV-2; Thrombosis - epidemiology; Venous thromboembolism
• ISSN: 0147-9563; 1527-3288
• DOI: 10.1016/j.hrtlng.2023.05.005

•Retrospective, cohort study utilized electronic medical records to asses clinical and thrombotic trends in patients with SARS-CoV-2 pneumonia(n=199) and other viral pneumonia (n=58).•There was no difference in composite primary outcome however renal replacement therapy (8.5% vs 0%, p=0.016) and mortality (15.6% vs 3.4%, p=0.048) occurred in the SARS-CoV-2 PNA group.•Multivariable logistic regression analysis revealed age, presence of SARS-CoV-2, and ICU admission, aOR 1.07, 11.37, and 41.95 respectively, was significantly associated with mortality risk during hospitalization; race and ethnicity were not. Infection with viral pneumonia (PNA) is known to offset the coagulation cascade. Recent studies assessing novel SARS-CoV-2 infection observed a high frequency of systemic thrombotic events resulting in ambiguity if severity of infection or specific viral strain drive thrombosis and worsen clinical outcomes. Furthermore, limited data exists addressing SARS-CoV-2 in underrepresented patient populations. Assess clinical outcomes events and death in patients diagnosed with SARS-CoV-2 pneumonia compared to patients with other types of viral pneumonia. Retrospective cohort study evaluated electronic medical records in adult patients admitted to University of Illinois Hospital and Health Sciences System (UIHHSS) with primary diagnosis of SARS-CoV-2 PNA or other viral (H1N1 or H3N2) PNA between 10/01/2017 and 09/01/2020. Primary composite outcome was the following event incidence rates: death, ICU admission, infection, thrombotic complications, mechanical ventilation, renal replacement therapy, and major bleeding. Of 257 patient records, 199 and 58 patients had SARS-CoV-2 PNA and other viral PNA, respectively. There was no difference in primary composite outcome. Thrombotic events (n = 6, 3%) occurred solely in SARS-CoV-2 PNA patients in the ICU. A significantly higher incidence of renal replacement therapy (8.5% vs 0%, p=0.016) and mortality (15.6% vs 3.4%, p=0.048) occurred in the SARS-CoV-2 PNA group. Multivariable logistic regression analysis revealed age, presence of SARS-CoV-2, and ICU admission, aOR 1.07, 11.37, and 41.95 respectively, was significantly associated with mortality risk during hospitalization; race and ethnicity were not. Low overall incidence of thrombotic events occurred only in the SARS-CoV-2 PNA group. SARS-CoV-2 PNA may lead to higher incidence of clinical events than those observed in H3N2/H1N1 viral pneumonia, and that race/ethnicity d