1. Risk Factors, Clinical Presentation, Therapeutic Trends, and Outcomes in Arterial Thrombosis Complicating Unvaccinated COVID-19 Patients: A Systematic Review.
- Author
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Castro-Varela, Alejandra, Martinez-Magallanes, Daniela M, Reyes-Chavez, Maria Fernanda, Gonzalez-Rayas, Jose Manuel, Paredes-Vazquez, Jose Gildardo, Vazquez-Garza, Eduardo, Castillo-Perez, Mauricio, Flores-Sayavedra, Yoezer Z, Martinez, Arturo, Ramos Cazares, Ray Erick, Guajardo, Jaime, Lopez-de la Garza, Hector, Salinas-Casanova, Jose Alfredo, Betancourt, Hector, Molina-Rodriguez, Abigail Montserrat, Panneflek, Jathniel, Fabiani, Mario Alejandro, and Jerjes-Sanchez, Carlos
- Subjects
THROMBOSIS complications ,RISK assessment ,ANTICOAGULANTS ,TREATMENT effectiveness ,CARDIOVASCULAR diseases risk factors ,FIBRINOLYTIC agents ,DESCRIPTIVE statistics ,SYSTEMATIC reviews ,MEDLINE ,INTENSIVE care units ,ONLINE information services ,COVID-19 ,THROMBOSIS - Abstract
Data on characteristics and outcomes of coronavirus (COVID)-19 patients complicated with arterial thrombosis (AT) are scarce. Therefore, we carried out a systematic review (PRISMA, PROSPERO statements; PubMed, Scopus, and Web of Science) to identify risk factors, clinical presentation, treatment, and outcomes. We included publications from December 2019 to October 2020. Groups: (a) ischemic stroke, (b) thrombotic storm, (c) peripheral vascular thrombosis, (d) myocardial infarction, and (e) left cardiac thrombus or in-transit thrombus (venous system thrombus floating or attaching to the right heart). We considered 131 studies. The most frequent cardiovascular risk factors were: hypertension, diabetes, and dyslipidemia. A high proportion presented with asymptomatic, mild, or moderate COVID-19 (n = 91, 41.4%). We identified a high percentage of isolated ischemic stroke and thrombotic storm. Groups with higher mortality rate: intracardiac thrombus (1/2, 50.0%), thrombotic storm (18/49, 36.7%), and ischemic stroke (48/131, 36.6%). A small number received thromboprophylaxis. Most patients received antithrombotic treatment. The most frequent bleeding complication was intracranial hemorrhage, primarily with isolated stroke. Overall mortality was 33.6% (74/220). Despite a wide range of COVID-19 severity, a high proportion had AT as a complication of non-severe disease. AT can affect different vascular territories; mortality is associated with stroke, intensive care unit stay, and severe COVID-19. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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