Assessment of thromboembolism risk in COVID-19 patients with cardiovascular disease risk factors: Analysis of a Japanese Nationwide Registry

Patients with COVID-19 and cardiovascular disease risk factors (CVDRF) have been reported to develop coagulation abnormalities frequently. However, there are limitations in conventional predictive models for the occurrence of thromboembolism in patients with COVID-19 and CVDRF. Among data on 1518 ho...

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Published in:Thrombosis research 2022-08, Vol.216, p.90-96
Main Authors: Shibahashi, Eiji, Jujo, Kentaro, Kuroda, Shunsuke, Matsumoto, Shingo, Sano, Takahide, Kitai, Takeshi, Yonetsu, Taishi, Kohsaka, Shun, Torii, Sho, Yamaguchi, Tetsuo, Kishi, Takuya, Komuro, Issei, Hirata, Kenichi, Node, Koichi, Matsue, Yuya
Format: Article
Language:English
Subjects:
Cardiovascular Diseases - complications
Cohort Studies
COVID-19 - complications
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Humans
Japan - epidemiology
Male
Registries
Retrospective Studies
Risk Factors
SARS-CoV-2
Venous Thromboembolism - epidemiology
Venous Thromboembolism - etiology
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Summary:Patients with COVID-19 and cardiovascular disease risk factors (CVDRF) have been reported to develop coagulation abnormalities frequently. However, there are limitations in conventional predictive models for the occurrence of thromboembolism in patients with COVID-19 and CVDRF. Among data on 1518 hospitalized patients with COVID-19 registered with CLAVIS-COVID, a Japanese nationwide cohort study, 693 patients with CVDRF were subjected to least absolute shrinkage and selection operator (LASSO) analysis; a method of shrinking coefficients for reducing variance and minimizing bias to increase predictive accuracy. LASSO analysis was performed to identify risk factors for systemic thromboembolic events; occurrence of arterial and venous thromboembolism during the index hospitalization as the primary endpoint. LASSO analysis identified a prior systemic thromboembolism, male sex, hypoxygenemia requiring invasive mechanical ventilation support, C-reactive protein levels and D-dimer levels at admission, and congestion on chest X-ray at admission as potential risk factors for the primary endpoint. The developed risk model consisting of these risk factors showed good discriminative performance (AUC-ROC: 0.83, 95 % confidence interval [CI]: 0.77-0.90), which was significantly better than that shown by D-dimer (AUC-ROC: 0.70, 95 % CI: 0.60-0.80) (p 
ISSN:0049-3848
1879-2472
DOI:10.1016/j.thromres.2022.06.007