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2. Towards optimal use of antithrombotic therapy of people with cancer at the end of life:A research protocol for the development and implementation of the SERENITY shared decision support tool

Author

Goedegebuur, J., Abbel, D., Accassat, S., Achterberg, W. P., Akbari, A., Arfuch, V. M., Baddeley, E., Bax, J. J., Becker, D., Bergmeijer, B., Bertoletti, L., Blom, J. W., Calvetti, A., Cannegieter, S. C., Castro, L., Chavannes, N. H., Coma-Auli, N., Couffignal, C., Edwards, A., Edwards, M., Enggaard, H., Font, C., Gava, A., Geersing, G. J., Geijteman, E. C.T., Greenley, S., Gregory, C., Gussekloo, J., Hoffmann, I., Højen, A. A., van den Hout, W. B., Huisman, M. V., Jacobsen, S., Jagosh, J., Johnson, M. J., Jørgensen, L., Juffermans, C. C.M., Kempers, E. K., Konstantinides, S., Kroder, A. F., Kruip, M. J.H.A., Lafaie, L., Langendoen, J. W., Larsen, T. B., Lifford, K., van der Linden, Y. M., Mahé, I., Maiorana, L., Maraveyas, A., Martens, E. S.L., Mayeur, D., van Mens, T. E., Mohr, K., Mooijaart, S. P., Murtagh, F. E.M., Nelson, A., Nielsen, P. B., Ording, A. G., Ørskov, M., Pearson, M., Poenou, G., Portielje, J. E.A., Raczkiewicz, D., Rasmussen, K., Trinks-Roerdink, E., Schippers, I., Seddon, K., Sexton, K., Sivell, S., Skjøth, F., Søgaard, M., Szmit, S., Trompet, S., Vassal, P., Visser, C., van Vliet, L. M., Wilson, E., Klok, F. A., Noble, S. I.R., Goedegebuur, J., Abbel, D., Accassat, S., Achterberg, W. P., Akbari, A., Arfuch, V. M., Baddeley, E., Bax, J. J., Becker, D., Bergmeijer, B., Bertoletti, L., Blom, J. W., Calvetti, A., Cannegieter, S. C., Castro, L., Chavannes, N. H., Coma-Auli, N., Couffignal, C., Edwards, A., Edwards, M., Enggaard, H., Font, C., Gava, A., Geersing, G. J., Geijteman, E. C.T., Greenley, S., Gregory, C., Gussekloo, J., Hoffmann, I., Højen, A. A., van den Hout, W. B., Huisman, M. V., Jacobsen, S., Jagosh, J., Johnson, M. J., Jørgensen, L., Juffermans, C. C.M., Kempers, E. K., Konstantinides, S., Kroder, A. F., Kruip, M. J.H.A., Lafaie, L., Langendoen, J. W., Larsen, T. B., Lifford, K., van der Linden, Y. M., Mahé, I., Maiorana, L., Maraveyas, A., Martens, E. S.L., Mayeur, D., van Mens, T. E., Mohr, K., Mooijaart, S. P., Murtagh, F. E.M., Nelson, A., Nielsen, P. B., Ording, A. G., Ørskov, M., Pearson, M., Poenou, G., Portielje, J. E.A., Raczkiewicz, D., Rasmussen, K., Trinks-Roerdink, E., Schippers, I., Seddon, K., Sexton, K., Sivell, S., Skjøth, F., Søgaard, M., Szmit, S., Trompet, S., Vassal, P., Visser, C., van Vliet, L. M., Wilson, E., Klok, F. A., and Noble, S. I.R.

Abstract

Background: Even though antithrombotic therapy has probably little or even negative effects on the well-being of people with cancer during their last year of life, deprescribing antithrombotic therapy at the end of life is rare in practice. It is often continued until death, possibly resulting in excess bleeding, an increased disease burden and higher healthcare costs. Methods: The SERENITY consortium comprises researchers and clinicians from eight European countries with specialties in different clinical fields, epidemiology and psychology. SERENITY will use a comprehensive approach combining a realist review, flash mob research, epidemiological studies, and qualitative interviews. The results of these studies will be used in a Delphi process to reach a consensus on the optimal design of the shared decision support tool. Next, the shared decision support tool will be tested in a randomised controlled trial. A targeted implementation and dissemination plan will be developed to enable the use of the SERENITY tool across Europe, as well as its incorporation in clinical guidelines and policies. The entire project is funded by Horizon Europe. Results: SERENITY will develop an information-driven shared decision support tool that will facilitate treatment decisions regarding the appropriate use of antithrombotic therapy in people with cancer at the end of life. Conclusions: We aim to develop an intervention that guides the appropriate use of antithrombotic therapy, prevents bleeding complications, and saves healthcare costs. Hopefully, usage of the tool leads to enhanced empowerment and improved quality of life and treatment satisfaction of people with advanced cancer and their care givers.

Published
2023

7. Lupus anticoagulant associates with thrombosis in patients with COVID-19 admitted to intensive care units

Author

Noordermeer, Tessa, Schutgens, Roger E. G., Visser, Chantal, Rademaker, Emma, de Maat, Moniek P. M., Jansen, A. J. Gerard, Limper, Maarten, Cremer, Olaf L., Kruip, Marieke J. H. A., Endeman, Henrik, Maas, Coen, de Laat, Bas, Urbanus, Rolf T., van de Beek, D., Brouwer, M. C., de Bruin, S., Coppens, M., van Es, N., van Haaps, T. F., Juffermans, N. P., Muller, M. C. A., Vlaar, A. P. J., Hertogh, C. M. P. M., Heunks, L. M. A., Hugtenburg, J. G., van Kooten, J., Nossent, E. J., Smulders, Y., Tuinman, P. R., Noordegraaf, A. Vonk, Grootenboers, M. J. J. H., van Guldener, C., Kant, M., Lansbergen, A., Faber, J., Hajer, G., Stemerdink, A., van den Akker, J., Bierings, R., Endeman, H., Goeijenbier, M., Hunfeld, N. G. M., van Gorp, E. C. M., Gommers, D. A. M. P. J., Koopmans, M. P. G., Kruip, M. J. H. A., Kuiken, T., Langerak, T., Leebeek, Lauw, M. N., de Maat, M. P. M., Noack, D., Paats, M. S., Raadsen, M. P., Rockx, B., Rokx, C., Schurink, C. A. M., Tong-Minh, K., van den Toorn, L., den Uil, C. A., Visser, C., Boutkourt, F., Roest, T., Douma, R. A., de Haan, L. R., ten Wolde, M., Bemelmans, R. H. H., Festen, B., Stads, S., de Jager, C. P. C., Simons, K. S., Antoni, M. L., Bos, M. H., Burggraaf, J. L. I., Cannegieter, S. C., Eikenboom, H. C. J., den Exter, P. L., Geelhoed, J. J. M., Huisman, M. V., de Jonge, E., Kaptein, F. H. J., Klok, F. A., Kroft, L. J. M., Lijfering, W. M., Nab, L., Ninaber, M. K., Putter, H., Ramai, S. R. S., da Rocha Rondon, A. M., Roukens, A. H. E., Stals, M. A. M., Versteeg, H. H., Vliegen, H. W., van Vlijmen, B. J. M., van de Berg, T., Bruggemann, R., van Bussel, B. C. T., ten Cate, H., ten Cate-Hoek, A., Hackeng, T. M., Henskens, ir. Y., Hulshof, A., Mulder, M., Olie, R. H., Schurgers, L., Spaetgens, B., Spronk, H., Spruit, M. A., Winckers, K., Nieuwenhuizen, L., Franken, B., Schrover, I. M., de Waal, E. G. M., Beishuizen, A., Cornet, A., Krabbe, J., Kramers, K., Leentjens, J., de Mast, Q., Middeldorp, S., Brouwer, R. E., Ellerbroek, J. L. J., Tijmensen, J., Hovens, M. M. C., Oostdijk, E. A. N., Westerhof, B. D., Faber, L. M., van den Biggelaar, M., Meijers, J. C. M., Voorberg, J., Kevenaar, M. E., Soei, Y. L., Wils, E. J., Croles, F. N., de Laat, B., Kamphuisen, P. W., Vink, R., Lisman, T., Meijer, K., van Tichelaar, Y. I. G., Cremer, O. L., Geersing, G., Kaasjager, H. A. H., Kusadasi, N., Huisman, A., Maas, C., Nijkeuter, M., Schutgens, R. E. G., Creveldkliniek, Van, Urbanus, R. T., Westerink, J., Faber, H. J., Koster, S. C. E., van Montfort, P., van Twist, D. J. L., RS: Carim - B01 Blood proteins & engineering, Biochemie, Hematology, Intensive Care, Neurology, ANS - Neuroinfection & -inflammation, Intensive Care Medicine, ACS - Pulmonary hypertension & thrombosis, AII - Inflammatory diseases, Vascular Medicine, ACS - Amsterdam Cardiovascular Sciences, Graduate School, ACS - Microcirculation, Medical Microbiology and Infection Prevention, ARD - Amsterdam Reproduction and Development, Experimental Vascular Medicine, Landsteiner Laboratory, ACS - Atherosclerosis & ischemic syndromes, Elderly care medicine, APH - Aging & Later Life, Clinical pharmacology and pharmacy, APH - Health Behaviors & Chronic Diseases, Pulmonary medicine, Internal medicine, ACS - Diabetes & metabolism, Intensive care medicine, General practice, and Amsterdam Gastroenterology Endocrinology Metabolism

Subjects
lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4], lupus anticoagulant, risk factor, critically ill, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4], COVID-19, Hematology, thrombosis, Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18]
Abstract

Contains fulltext : 286889.pdf (Publisher’s version ) (Open Access) BACKGROUND: Thrombosis is a frequent and severe complication in patients with coronavirus disease 2019 (COVID-19) admitted to the intensive care unit (ICU). Lupus anticoagulant (LA) is a strong acquired risk factor for thrombosis in various diseases and is frequently observed in patients with COVID-19. Whether LA is associated with thrombosis in patients with severe COVID-19 is currently unclear. OBJECTIVE: To investigate if LA is associated with thrombosis in critically ill patients with COVID-19. PATIENTS/METHODS: The presence of LA and other antiphospholipid antibodies was assessed in patients with COVID-19 admitted to the ICU. LA was determined with dilute Russell's viper venom time (dRVVT) and LA-sensitive activated partial thromboplastin time (aPTT) reagents. RESULTS: Of 169 patients with COVID-19, 116 (69%) tested positive for at least one antiphospholipid antibody upon admission to the ICU. Forty (24%) patients tested positive for LA; of whom 29 (17%) tested positive with a dRVVT, 19 (11%) tested positive with an LA-sensitive aPTT, and 8 (5%) tested positive on both tests. Fifty-eight (34%) patients developed thrombosis after ICU admission. The odds ratio (OR) for thrombosis in patients with LA based on a dRVVT was 2.5 (95% confidence interval [CI], 1.1-5.7), which increased to 4.5 (95% CI, 1.4-14.3) in patients at or below the median age in this study (64 years). LA positivity based on a dRVVT or LA-sensitive aPTT was only associated with thrombosis in patients aged less than 65 years (OR, 3.8; 95% CI, 1.3-11.4) and disappeared after adjustment for C-reactive protein. CONCLUSION: Lupus anticoagulant on admission is strongly associated with thrombosis in critically ill patients with COVID-19, especially in patients aged less than 65 years.

Published
2022
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11. Recommendations from the ICM-VTE: General

Author

Parvizi, J., Abbas, A. A., Abcha, O., Abdelaal, M. S., Ackermann, P. W., Acuna, A. J., Ageno, W., Aguilar Ramirez, J. J., Akkaya, M., Alameddine, D., Alfaro, D. O., Alvand, A., Alzeedi, M., Andrade, A. J., Arnold, W. V., Arish, A., Austin, M. S., Ay, C., Azboy, I., Babis, G. C., Baker, C. M., Barrack, R. L., Barragan, E., Beaton-Comulada, D., Bedair, H. S., Bell, J. A., Beverland, D. E., Bhatia, N., Bialecki, J., Bondarenko, S., Bonilla, G., River Boschert, S. O., Bracho, C., Brooks, D., Buttaro, M., Cacan Daniel Caldeira, M. A., Callaghan, J., Campbell, D. G., Cancienne, J. M., Cannegieter, S. C., Canseco, J. A., Caprini, J. A., Carrier, M., Castro Bejarano, J. C., Catani, F., Ceylan, H. H., Cha, Y. -H., Chan, C. K., Chan, N., Cheung, M. H., Chisari, E., Cimminiello, C., Citak, M., Colon-Miranda, R. G., Colwell, C., Combs, K., Cordeiro, M., Corvi, J. J., Courtney Crispiana Cozowicz, P. M., Crawford, R. W., Cruz, E., D'Amore, T., Dantas, P., Della Valle, A. G., Deltour, C., Demanes, A. C., Djaja, Y. P., Dunbar, M. J., Egoavil, M. S., Egol, K. A., Eichinger, S., Elias, L. F., Emmerson, B. R., Ettema, H. B., Al Farii, H., Fernandez-Rodriguez, D., Fillingham, Y. A., Fu, H., Gallagher, N., Gary, J. L., Geerts, W. H., Ghazavi, M. T., Gleason, B., Goh, G. S., Goncalves, S., Goriainov, V., Goswami, K., Goyal, L., Granqvist, M., Grenho, A., Griffin, X., Hafez, M. A., Hakyemez, O. S., Hamdi, S., Hansen, E. N., Hansen, H., Hasegawa, M., Higuera, C. A., Hobohm, L. M. A., Holc, F., Hollingsworth, N., Hozack, W. J., Hughes, A. J., Humphrey, T. J., Huo, M. H., Inaba, Y., Jenny, J. -Y., Jiranek, W., Kaila, R., Kallel, S., Kamath, A. F., Karachalios, T., Karas, V., Kelkar, A. H., Keller, K., Kenanidis, E., Khan, I. A., Khan, Y., Kim, J. -H., Kim, K. -I., Klein, G. R., Kleiner, J. E., Komnos, G., Konstantinides, S. V., Koo, K. -H., Kopenitz, J., Krasinski, Z., Krueger, C. A., Kuo, A., Kvederas, G., Kwong, L. M., Lachiewicz, P. F., De Ladoucette, A., Larco, E., Larkin, J. A., Levine, B. R., W. T., Li, Lieberman, J. R., Lip, G. Y. H., Lizarraga, M. M., Llinas, A., Lobastov, K., Lobo, C. A., Ludwick, L., Julian, F., Maempel, Magnuson, J., Maini, L., Maltseva, V., Mamczak, C. N., Garcia-Mansilla, A., Manzaneda, M. E., Martino, V., Al Maskari, S., Matharu, G. S., Mead, M., Meghpara, M. M., Mehta, S., Memtsoudis, S. G., Menon, D., Merli Nikolaos Milonakis, G. J., Mirkazemi, C., Mojica, J. J., Moka, E., Moncman, T. G., Monsalvo, D., Mortazavi, S. M. J., Morton, J., Mulcahey, M. K., Najafi, F., Nam, D., Namdari, S., Navarro, R., Nazarian, D. G., Niikura, T., Noyez, J. F., Ochoa Chaar, C. I., Ong, C. B., Otero-Lopez, A., Ozaki, T., Pandit, H., Pannu, T. S., Parvizi, N., Poeran, J., Poolman, R. W., Purtill, J. J., Radoicic, D. K., Rajasekaran, R. B., Rajasekhar, A., Randelli, F., Reed, M., Restrepo, C., Riva, N., Romanini, E., Sadek, M., Saglam, Y., Salazar, G., Salazar, M., Salvati, E. A., Samama, C. M., Sanchez-Osorio, J. S., Santoso, A., Sattarzadeh, R., Saxena, A., Schemitsch, E., Schulman, S., Schwenk, E. S., Shahi, A., Sharkey, P. F., Sharrock, N., Shivakumar, S., Shohat, N., Siegel, N. M., Sievers, D. A., Smailys, A., Smith, E. B., Somers, J. F. A., Souissi, M., Sousa, P., Sousa, R., Spyropoulos, A. C., Squizzato, A., Srivastava, A., Suarez, C., Suresh, S., Tannoury, T., Tarabichi, M., Tarabichi, S., Taylor, J., Terhune, E. B., Thienpont, E., Thomas, T. L., Top, A. C., Tornetta, P., Torres, A., Torres-Lugo, N. J., Tort-Saade, P., Tresgallo-Pares, R., Tsiridis, E., Tuncay, I., Urbanek, T., Urish, K. L., Vendittoli, P. -A., Victor, K., Vilchez, F., Villa, J. M., Viscusi, E. R., Volk, T., Vosooghi, F., Vysotskyi, O., Walsh, M., Warren, J., Werner, B. C., Westrich, G., Whitehouse, M. R., Whitehouse, S. L., Winters, B. S., Wouthuyzen-Bakker, M., Yamada, K., Yates, A. J., Yoo, J. -I., Yoon, U., Zambianchi, F., UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, and Delegates, ICM-VTE General

Subjects
Risk Factors, Anticoagulants, Humans, Orthopedics and Sports Medicine, Surgery, General Medicine, Venous Thromboembolism
Published
2022

12. Current clinical practice for thromboprophylaxis management in patients with Cushing's syndrome across reference centers of the European Reference Network on Rare Endocrine Conditions (Endo-ERN).

Author

UCL - SSS/IREC/EDIN - Pôle d'endocrinologie, diabète et nutrition, UCL - (SLuc) Service d'endocrinologie et de nutrition, van Haalen, F M, Kaya, M, Pelsma, I C M, Dekkers, O M, Biermasz, N R, Cannegieter, S C, Huisman, M V, van Vlijmen, B J M, Feelders, R A, Klok, F A, Pereira, A M, Endo-ERN Cushing and Thrombosis study group, Maiter, Dominique, UCL - SSS/IREC/EDIN - Pôle d'endocrinologie, diabète et nutrition, UCL - (SLuc) Service d'endocrinologie et de nutrition, van Haalen, F M, Kaya, M, Pelsma, I C M, Dekkers, O M, Biermasz, N R, Cannegieter, S C, Huisman, M V, van Vlijmen, B J M, Feelders, R A, Klok, F A, Pereira, A M, Endo-ERN Cushing and Thrombosis study group, and Maiter, Dominique

Abstract

BACKGROUND: Cushing's syndrome (CS) is associated with an hypercoagulable state and an increased risk of venous thromboembolism (VTE). Evidence-based guidelines on thromboprophylaxis strategies in patients with CS are currently lacking. We aimed to map the current clinical practice for thromboprophylaxis management in patients with CS across reference centers (RCs) of the European Reference Network on Rare Endocrine Conditions (Endo-ERN), which are endorsed specifically for the diagnosis and treatment of CS. Using the EU survey tool, a primary screening survey, and subsequently a secondary, more in-depth survey were developed. RESULTS: The majority of the RCs provided thromboprophylaxis to patients with CS (n = 23/25), although only one center had a standardized thromboprophylaxis protocol (n = 1/23). RCs most frequently started thromboprophylaxis from CS diagnosis onwards (n = 11/23), and the majority stopped thromboprophylaxis based on individual patient characteristics, rather than standardized treatment duration (n = 15/23). Factors influencing the initiation of thromboprophylaxis were 'medical history of VTE' (n = 15/23) and 'severity of hypercortisolism' (n = 15/23). Low-Molecular-Weight-Heparin was selected as the first-choice anticoagulant drug for thromboprophylaxis by all RCs (n = 23/23). Postoperatively, the majority of RCs reported 'severe immobilization' as an indication to start thromboprophylaxis in patients with CS (n = 15/25). Most RCs (n = 19/25) did not provide standardized testing for variables of hemostasis in the postoperative care of CS. Furthermore, the majority of the RCs provided preoperative medical treatment to patients with CS (n = 23/25). About half of these RCs (n = 12/23) took a previous VTE into account when starting preoperative medical treatment, and about two-thirds (n = 15/23) included 'reduction of VTE risk' as a goal of treatment. CONCLUSIONS: There is a large practice variation regarding thromboprophylaxis management and perio

Published
2022

13. Additional file 3 of Current clinical practice for thromboprophylaxis management in patients with Cushing’s syndrome across reference centers of the European Reference Network on Rare Endocrine Conditions (Endo-ERN)

Author

van Haalen, F. M., Kaya, M., Pelsma, I. C. M., Dekkers, O. M., Biermasz, N. R., Cannegieter, S. C., Huisman, M. V., van Vlijmen, B. J. M., Feelders, R. A., Klok, F. A., and Pereira, A. M.

Subjects
behavioral disciplines and activities
Abstract

Additional file 3: Epidemiological data of Cushing’s syndrome patient population across the Endo-ERN.

Published
2022
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14. Additional file 5 of Current clinical practice for thromboprophylaxis management in patients with Cushing’s syndrome across reference centers of the European Reference Network on Rare Endocrine Conditions (Endo-ERN)

Author

van Haalen, F. M., Kaya, M., Pelsma, I. C. M., Dekkers, O. M., Biermasz, N. R., Cannegieter, S. C., Huisman, M. V., van Vlijmen, B. J. M., Feelders, R. A., Klok, F. A., and Pereira, A. M.

Abstract

Additional file 5: Secondary survey.

Published
2022
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15. Additional file 4 of Current clinical practice for thromboprophylaxis management in patients with Cushing’s syndrome across reference centers of the European Reference Network on Rare Endocrine Conditions (Endo-ERN)

Author

van Haalen, F. M., Kaya, M., Pelsma, I. C. M., Dekkers, O. M., Biermasz, N. R., Cannegieter, S. C., Huisman, M. V., van Vlijmen, B. J. M., Feelders, R. A., Klok, F. A., and Pereira, A. M.

Abstract

Additional file 4: Primary survey.

Published
2022
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16. Additional file 2 of Current clinical practice for thromboprophylaxis management in patients with Cushing’s syndrome across reference centers of the European Reference Network on Rare Endocrine Conditions (Endo-ERN)

Author

van Haalen, F. M., Kaya, M., Pelsma, I. C. M., Dekkers, O. M., Biermasz, N. R., Cannegieter, S. C., Huisman, M. V., van Vlijmen, B. J. M., Feelders, R. A., Klok, F. A., and Pereira, A. M.

Subjects
Data_FILES
Abstract

Additional file 2: Definitions used by the reference centers.

Published
2022
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17. Additional file 1 of Current clinical practice for thromboprophylaxis management in patients with Cushing’s syndrome across reference centers of the European Reference Network on Rare Endocrine Conditions (Endo-ERN)

Author

van Haalen, F. M., Kaya, M., Pelsma, I. C. M., Dekkers, O. M., Biermasz, N. R., Cannegieter, S. C., Huisman, M. V., van Vlijmen, B. J. M., Feelders, R. A., Klok, F. A., and Pereira, A. M.

Abstract

Additional file 1: Characteristics of care for Cushing’s syndrome patients at the reference centers.

Published
2022
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47. Incidence of thrombotic complications and overall survival in hospitalized patients with COVID-19 in the second and first wave

Author

Kaptein, F H J, Stals, M A M, Grootenboers, M, Braken, S J E, Burggraaf, J L I, van Bussel, B C T, Cannegieter, S C, Ten Cate, H, Endeman, H, Gommers, D A M P J, van Guldener, C, de Jonge, E, Juffermans, N P, Kant, K M, Kevenaar, M E, Koster, S, Kroft, L J M, Kruip, M J H A, Leentjens, J, Marechal, C, Soei, Y L, Tjepkema, L, Visser, C, Klok, F A, Huisman, M V, Kaptein, F H J, Stals, M A M, Grootenboers, M, Braken, S J E, Burggraaf, J L I, van Bussel, B C T, Cannegieter, S C, Ten Cate, H, Endeman, H, Gommers, D A M P J, van Guldener, C, de Jonge, E, Juffermans, N P, Kant, K M, Kevenaar, M E, Koster, S, Kroft, L J M, Kruip, M J H A, Leentjens, J, Marechal, C, Soei, Y L, Tjepkema, L, Visser, C, Klok, F A, and Huisman, M V

Abstract

INTRODUCTION: In the first wave, thrombotic complications were common in COVID-19 patients. It is unknown whether state-of-the-art treatment has resulted in less thrombotic complications in the second wave.METHODS: We assessed the incidence of thrombotic complications and overall mortality in COVID-19 patients admitted to eight Dutch hospitals between September 1st and November 30th 2020. Follow-up ended at discharge, transfer to another hospital, when they died, or on November 30th 2020, whichever came first. Cumulative incidences were estimated, adjusted for competing risk of death. These were compared to those observed in 579 patients admitted in the first wave, between February 24th and April 26th 2020, by means of Cox regression techniques adjusted for age, sex and weight.RESULTS: In total 947 patients with COVID-19 were included in this analysis, of whom 358 patients were admitted to the ICU; 144 patients died (15%). The adjusted cumulative incidence of all thrombotic complications after 10, 20 and 30 days was 12% (95% confidence interval (CI) 9.8-15%), 16% (13-19%) and 21% (17-25%), respectively. Patient characteristics between the first and second wave were comparable. The adjusted hazard ratio (HR) for overall mortality in the second wave versus the first wave was 0.53 (95%CI 0.41-0.70). The adjusted HR for any thrombotic complication in the second versus the first wave was 0.89 (95%CI 0.65-1.2).CONCLUSIONS: Mortality was reduced by 47% in the second wave, but the thrombotic complication rate remained high, and comparable to the first wave. Careful attention to provision of adequate thromboprophylaxis is invariably warranted.

Published
2021

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