Incidence and mortality due to thromboembolic events during the COVID-19 pandemic: Multi-sourced population-based health records cohort study

Evidence supports an excess of deaths during the COVID-19 pandemic. We report the incidence and mortality of thrombo-embolic events (TE) during the COVID-19 pandemic. Multi-sourced nationwide cohort study of adults (age ≥18 years) admitted to hospital with TE and deaths from TE in England (hospital...

Celý popis

Uloženo v:
Podrobná bibliografie
Vydáno v:Thrombosis research Ročník 202; s. 17 - 23
Hlavní autoři: Aktaa, Suleman, Wu, Jianhua, Nadarajah, Ramesh, Rashid, Muhammad, de Belder, Mark, Deanfield, John, Mamas, Mamas A., Gale, Chris P.
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States Elsevier Ltd 01.06.2021
Témata:
ISSN:0049-3848, 1879-2472, 1879-2472
On-line přístup:Získat plný text
Tagy: Přidat tag
Žádné tagy, Buďte první, kdo vytvoří štítek k tomuto záznamu!
Abstract Evidence supports an excess of deaths during the COVID-19 pandemic. We report the incidence and mortality of thrombo-embolic events (TE) during the COVID-19 pandemic. Multi-sourced nationwide cohort study of adults (age ≥18 years) admitted to hospital with TE and deaths from TE in England (hospital and community) between 1st February 2018 and 31st July 2020. Relative risks, adjusted for age, sex, atrial fibrillation, co-morbidities and time trend comparing before and during the COVID-19 pandemic were estimated using Poisson regression. Of 272,423 patients admitted with TE to 195 hospitals, 86,577 (31.8%) were admitted after 2nd March 2020 (first COVID-19 death in the UK). The incidence of TE hospitalised increased during the COVID-19 pandemic from 1090 to 1590 per 100,000 (absolute risk change 45.9% [95% CI 45.1–46.6%], adjusted relative risk [ARR] 1.43 [95% CI 1.41–1.44]) driven particularly by pulmonary embolism; 1.49, 95% CI 1.46–1.52. TE were more frequent among those with COVID-19; 1.9% vs. 1.6%, absolute risk change 21.7%, 95% CI 21.0–22.4%, ARR 1.20, 95% CI 1.18–1.22. There was an increase in the overall mortality from TE during the pandemic (617, 6.7% proportional increase compared with the historical baseline), with more TE deaths occurring in the community compared with the historical rate (44% vs. 33%). The COVID-19 pandemic has resulted in an increase in the incidence of hospitalised TE. There were more deaths from TE in the community highlighting a number of mechanisms including the hypercoagulable state associated with COVID-19 infection and potential impact of delays in seeking help. Evidence before this study We searched PubMed on 16 November 2020 for articles that documented the incidence and mortality of thrombo-embolic events (TE) during the COVID-19 pandemic using the search terms “COVID-19” OR “Coronavirus*” OR “2019-nCOV” OR “SARS-CoV” AND (“Thromboembolism” OR “Venous Thromboembolism” OR “thromboembol*”) with no language or time restrictions. The majority of data on TE in COVID-19 pertains to hospitalised patients from retrospective cohort studies. One study found that TE in hospitalised patients was associated with an increased mortality rate (adjusted hazard ratio 1.82; 95% CI 1.54–2.15). A systematic review and meta-analysis of 35 studies in 9249 hospitalised patients calculated an overall pooled incidence of TE of 17.8% (95% CI: 9.9–27.4%), rising to 22.9% (95% CI: 14.5–32.4%) in patients admitted to intensive care (ICU). The most contemporary data are from a cohort of 1114 patients (715 outpatient, 399 hospitalised, 170 admitted to ICU). With robust COVID-19-specific therapies and widespread thromboprophylaxis the prevalence of venous TE in ICU patients was reported as 7% (n = 12) when catheter-/device-related events were excluded, and among the outpatients there was no TE reported. No published studies have used nationwide data to investigate TE during the pandemic or the effect of the pandemic on outcomes of patients with TE but without Covid-19. Added value of this study This retrospective multi-sourced nationwide unlinked cohort study compares the overall incidence and mortality of TE prior to and during the COVID-19 pandemic. We found an increased incidence of TE despite only a small proportion having a diagnosis of COVID-19. This may highlight the lack of testing, particularly in the community during the initial phase of the pandemic, and the possibility of other factors contributing to TE risk, such as decreased daily activity mandated by home quarantine and alterations in medication concordance. Mortality from TE was higher in the community during the pandemic and this highlights that adverse societal effects of the pandemic, such as aversion to seeking medical assessment, may precipitate worse outcomes related to TE. Implications of all the available evidence Evidence suggests that COVID-19 produces a hypercoagulable state and thromboprophylaxis is recommended in hospitalised patients to prevent excess mortality from TE. Whether to anticoagulate non-hospitalised ambulatory patients with COVID-19 will be answered by ongoing trials. Clinicians should consider the risks posed by decreased daily activity and fear of medical contact, and provide appropriate advice to patients. [Display omitted] •Thrombo-embolic event (TE) have been described as one of the major cardiovascular complications of COVID-19.•The incidence of TE hospitalised increased during the COVID-19 pandemic.•The increase was driven particularly by pulmonary embolism.•TE were more frequent among those with COVID-19.•More TE deaths occurred in the community during the COVID-19 pandemic compared with the previous years.
AbstractList Evidence supports an excess of deaths during the COVID-19 pandemic. We report the incidence and mortality of thrombo-embolic events (TE) during the COVID-19 pandemic. Multi-sourced nationwide cohort study of adults (age ≥18 years) admitted to hospital with TE and deaths from TE in England (hospital and community) between 1st February 2018 and 31st July 2020. Relative risks, adjusted for age, sex, atrial fibrillation, co-morbidities and time trend comparing before and during the COVID-19 pandemic were estimated using Poisson regression. Of 272,423 patients admitted with TE to 195 hospitals, 86,577 (31.8%) were admitted after 2nd March 2020 (first COVID-19 death in the UK). The incidence of TE hospitalised increased during the COVID-19 pandemic from 1090 to 1590 per 100,000 (absolute risk change 45.9% [95% CI 45.1-46.6%], adjusted relative risk [ARR] 1.43 [95% CI 1.41-1.44]) driven particularly by pulmonary embolism; 1.49, 95% CI 1.46-1.52. TE were more frequent among those with COVID-19; 1.9% vs. 1.6%, absolute risk change 21.7%, 95% CI 21.0-22.4%, ARR 1.20, 95% CI 1.18-1.22. There was an increase in the overall mortality from TE during the pandemic (617, 6.7% proportional increase compared with the historical baseline), with more TE deaths occurring in the community compared with the historical rate (44% vs. 33%). The COVID-19 pandemic has resulted in an increase in the incidence of hospitalised TE. There were more deaths from TE in the community highlighting a number of mechanisms including the hypercoagulable state associated with COVID-19 infection and potential impact of delays in seeking help. Evidence before this study We searched PubMed on 16 November 2020 for articles that documented the incidence and mortality of thrombo-embolic events (TE) during the COVID-19 pandemic using the search terms "COVID-19" OR "Coronavirus*" OR "2019-nCOV" OR "SARS-CoV" AND ("Thromboembolism" OR "Venous Thromboembolism" OR "thromboembol*") with no language or time restrictions. The majority of data on TE in COVID-19 pertains to hospitalised patients from retrospective cohort studies. One study found that TE in hospitalised patients was associated with an increased mortality rate (adjusted hazard ratio 1.82; 95% CI 1.54-2.15). A systematic review and meta-analysis of 35 studies in 9249 hospitalised patients calculated an overall pooled incidence of TE of 17.8% (95% CI: 9.9-27.4%), rising to 22.9% (95% CI: 14.5-32.4%) in patients admitted to intensive care (ICU). The most contemporary data are from a cohort of 1114 patients (715 outpatient, 399 hospitalised, 170 admitted to ICU). With robust COVID-19-specific therapies and widespread thromboprophylaxis the prevalence of venous TE in ICU patients was reported as 7% (n = 12) when catheter-/device-related events were excluded, and among the outpatients there was no TE reported. No published studies have used nationwide data to investigate TE during the pandemic or the effect of the pandemic on outcomes of patients with TE but without Covid-19. Added value of this study This retrospective multi-sourced nationwide unlinked cohort study compares the overall incidence and mortality of TE prior to and during the COVID-19 pandemic. We found an increased incidence of TE despite only a small proportion having a diagnosis of COVID-19. This may highlight the lack of testing, particularly in the community during the initial phase of the pandemic, and the possibility of other factors contributing to TE risk, such as decreased daily activity mandated by home quarantine and alterations in medication concordance. Mortality from TE was higher in the community during the pandemic and this highlights that adverse societal effects of the pandemic, such as aversion to seeking medical assessment, may precipitate worse outcomes related to TE. Implications of all the available evidence Evidence suggests that COVID-19 produces a hypercoagulable state and thromboprophylaxis is recommended in hospitalised patients to prevent excess mortality from TE. Whether to anticoagulate non-hospitalised ambulatory patients with COVID-19 will be answered by ongoing trials. Clinicians should consider the risks posed by decreased daily activity and fear of medical contact, and provide appropriate advice to patients.
Unlabelled Image
Evidence supports an excess of deaths during the COVID-19 pandemic. We report the incidence and mortality of thrombo-embolic events (TE) during the COVID-19 pandemic. Multi-sourced nationwide cohort study of adults (age ≥18 years) admitted to hospital with TE and deaths from TE in England (hospital and community) between 1st February 2018 and 31st July 2020. Relative risks, adjusted for age, sex, atrial fibrillation, co-morbidities and time trend comparing before and during the COVID-19 pandemic were estimated using Poisson regression. Of 272,423 patients admitted with TE to 195 hospitals, 86,577 (31.8%) were admitted after 2nd March 2020 (first COVID-19 death in the UK). The incidence of TE hospitalised increased during the COVID-19 pandemic from 1090 to 1590 per 100,000 (absolute risk change 45.9% [95% CI 45.1–46.6%], adjusted relative risk [ARR] 1.43 [95% CI 1.41–1.44]) driven particularly by pulmonary embolism; 1.49, 95% CI 1.46–1.52. TE were more frequent among those with COVID-19; 1.9% vs. 1.6%, absolute risk change 21.7%, 95% CI 21.0–22.4%, ARR 1.20, 95% CI 1.18–1.22. There was an increase in the overall mortality from TE during the pandemic (617, 6.7% proportional increase compared with the historical baseline), with more TE deaths occurring in the community compared with the historical rate (44% vs. 33%). The COVID-19 pandemic has resulted in an increase in the incidence of hospitalised TE. There were more deaths from TE in the community highlighting a number of mechanisms including the hypercoagulable state associated with COVID-19 infection and potential impact of delays in seeking help. Evidence before this study We searched PubMed on 16 November 2020 for articles that documented the incidence and mortality of thrombo-embolic events (TE) during the COVID-19 pandemic using the search terms “COVID-19” OR “Coronavirus*” OR “2019-nCOV” OR “SARS-CoV” AND (“Thromboembolism” OR “Venous Thromboembolism” OR “thromboembol*”) with no language or time restrictions. The majority of data on TE in COVID-19 pertains to hospitalised patients from retrospective cohort studies. One study found that TE in hospitalised patients was associated with an increased mortality rate (adjusted hazard ratio 1.82; 95% CI 1.54–2.15). A systematic review and meta-analysis of 35 studies in 9249 hospitalised patients calculated an overall pooled incidence of TE of 17.8% (95% CI: 9.9–27.4%), rising to 22.9% (95% CI: 14.5–32.4%) in patients admitted to intensive care (ICU). The most contemporary data are from a cohort of 1114 patients (715 outpatient, 399 hospitalised, 170 admitted to ICU). With robust COVID-19-specific therapies and widespread thromboprophylaxis the prevalence of venous TE in ICU patients was reported as 7% (n = 12) when catheter-/device-related events were excluded, and among the outpatients there was no TE reported. No published studies have used nationwide data to investigate TE during the pandemic or the effect of the pandemic on outcomes of patients with TE but without Covid-19. Added value of this study This retrospective multi-sourced nationwide unlinked cohort study compares the overall incidence and mortality of TE prior to and during the COVID-19 pandemic. We found an increased incidence of TE despite only a small proportion having a diagnosis of COVID-19. This may highlight the lack of testing, particularly in the community during the initial phase of the pandemic, and the possibility of other factors contributing to TE risk, such as decreased daily activity mandated by home quarantine and alterations in medication concordance. Mortality from TE was higher in the community during the pandemic and this highlights that adverse societal effects of the pandemic, such as aversion to seeking medical assessment, may precipitate worse outcomes related to TE. Implications of all the available evidence Evidence suggests that COVID-19 produces a hypercoagulable state and thromboprophylaxis is recommended in hospitalised patients to prevent excess mortality from TE. Whether to anticoagulate non-hospitalised ambulatory patients with COVID-19 will be answered by ongoing trials. Clinicians should consider the risks posed by decreased daily activity and fear of medical contact, and provide appropriate advice to patients. [Display omitted] •Thrombo-embolic event (TE) have been described as one of the major cardiovascular complications of COVID-19.•The incidence of TE hospitalised increased during the COVID-19 pandemic.•The increase was driven particularly by pulmonary embolism.•TE were more frequent among those with COVID-19.•More TE deaths occurred in the community during the COVID-19 pandemic compared with the previous years.
Evidence supports an excess of deaths during the COVID-19 pandemic. We report the incidence and mortality of thrombo-embolic events (TE) during the COVID-19 pandemic.BACKGROUNDEvidence supports an excess of deaths during the COVID-19 pandemic. We report the incidence and mortality of thrombo-embolic events (TE) during the COVID-19 pandemic.Multi-sourced nationwide cohort study of adults (age ≥18 years) admitted to hospital with TE and deaths from TE in England (hospital and community) between 1st February 2018 and 31st July 2020. Relative risks, adjusted for age, sex, atrial fibrillation, co-morbidities and time trend comparing before and during the COVID-19 pandemic were estimated using Poisson regression.METHODSMulti-sourced nationwide cohort study of adults (age ≥18 years) admitted to hospital with TE and deaths from TE in England (hospital and community) between 1st February 2018 and 31st July 2020. Relative risks, adjusted for age, sex, atrial fibrillation, co-morbidities and time trend comparing before and during the COVID-19 pandemic were estimated using Poisson regression.Of 272,423 patients admitted with TE to 195 hospitals, 86,577 (31.8%) were admitted after 2nd March 2020 (first COVID-19 death in the UK). The incidence of TE hospitalised increased during the COVID-19 pandemic from 1090 to 1590 per 100,000 (absolute risk change 45.9% [95% CI 45.1-46.6%], adjusted relative risk [ARR] 1.43 [95% CI 1.41-1.44]) driven particularly by pulmonary embolism; 1.49, 95% CI 1.46-1.52. TE were more frequent among those with COVID-19; 1.9% vs. 1.6%, absolute risk change 21.7%, 95% CI 21.0-22.4%, ARR 1.20, 95% CI 1.18-1.22. There was an increase in the overall mortality from TE during the pandemic (617, 6.7% proportional increase compared with the historical baseline), with more TE deaths occurring in the community compared with the historical rate (44% vs. 33%).FINDINGSOf 272,423 patients admitted with TE to 195 hospitals, 86,577 (31.8%) were admitted after 2nd March 2020 (first COVID-19 death in the UK). The incidence of TE hospitalised increased during the COVID-19 pandemic from 1090 to 1590 per 100,000 (absolute risk change 45.9% [95% CI 45.1-46.6%], adjusted relative risk [ARR] 1.43 [95% CI 1.41-1.44]) driven particularly by pulmonary embolism; 1.49, 95% CI 1.46-1.52. TE were more frequent among those with COVID-19; 1.9% vs. 1.6%, absolute risk change 21.7%, 95% CI 21.0-22.4%, ARR 1.20, 95% CI 1.18-1.22. There was an increase in the overall mortality from TE during the pandemic (617, 6.7% proportional increase compared with the historical baseline), with more TE deaths occurring in the community compared with the historical rate (44% vs. 33%).The COVID-19 pandemic has resulted in an increase in the incidence of hospitalised TE. There were more deaths from TE in the community highlighting a number of mechanisms including the hypercoagulable state associated with COVID-19 infection and potential impact of delays in seeking help.INTERPRETATIONThe COVID-19 pandemic has resulted in an increase in the incidence of hospitalised TE. There were more deaths from TE in the community highlighting a number of mechanisms including the hypercoagulable state associated with COVID-19 infection and potential impact of delays in seeking help.Evidence before this study We searched PubMed on 16 November 2020 for articles that documented the incidence and mortality of thrombo-embolic events (TE) during the COVID-19 pandemic using the search terms "COVID-19" OR "Coronavirus*" OR "2019-nCOV" OR "SARS-CoV" AND ("Thromboembolism" OR "Venous Thromboembolism" OR "thromboembol*") with no language or time restrictions. The majority of data on TE in COVID-19 pertains to hospitalised patients from retrospective cohort studies. One study found that TE in hospitalised patients was associated with an increased mortality rate (adjusted hazard ratio 1.82; 95% CI 1.54-2.15). A systematic review and meta-analysis of 35 studies in 9249 hospitalised patients calculated an overall pooled incidence of TE of 17.8% (95% CI: 9.9-27.4%), rising to 22.9% (95% CI: 14.5-32.4%) in patients admitted to intensive care (ICU). The most contemporary data are from a cohort of 1114 patients (715 outpatient, 399 hospitalised, 170 admitted to ICU). With robust COVID-19-specific therapies and widespread thromboprophylaxis the prevalence of venous TE in ICU patients was reported as 7% (n = 12) when catheter-/device-related events were excluded, and among the outpatients there was no TE reported. No published studies have used nationwide data to investigate TE during the pandemic or the effect of the pandemic on outcomes of patients with TE but without Covid-19. Added value of this study This retrospective multi-sourced nationwide unlinked cohort study compares the overall incidence and mortality of TE prior to and during the COVID-19 pandemic. We found an increased incidence of TE despite only a small proportion having a diagnosis of COVID-19. This may highlight the lack of testing, particularly in the community during the initial phase of the pandemic, and the possibility of other factors contributing to TE risk, such as decreased daily activity mandated by home quarantine and alterations in medication concordance. Mortality from TE was higher in the community during the pandemic and this highlights that adverse societal effects of the pandemic, such as aversion to seeking medical assessment, may precipitate worse outcomes related to TE. Implications of all the available evidence Evidence suggests that COVID-19 produces a hypercoagulable state and thromboprophylaxis is recommended in hospitalised patients to prevent excess mortality from TE. Whether to anticoagulate non-hospitalised ambulatory patients with COVID-19 will be answered by ongoing trials. Clinicians should consider the risks posed by decreased daily activity and fear of medical contact, and provide appropriate advice to patients.RESEARCH IN CONTEXTEvidence before this study We searched PubMed on 16 November 2020 for articles that documented the incidence and mortality of thrombo-embolic events (TE) during the COVID-19 pandemic using the search terms "COVID-19" OR "Coronavirus*" OR "2019-nCOV" OR "SARS-CoV" AND ("Thromboembolism" OR "Venous Thromboembolism" OR "thromboembol*") with no language or time restrictions. The majority of data on TE in COVID-19 pertains to hospitalised patients from retrospective cohort studies. One study found that TE in hospitalised patients was associated with an increased mortality rate (adjusted hazard ratio 1.82; 95% CI 1.54-2.15). A systematic review and meta-analysis of 35 studies in 9249 hospitalised patients calculated an overall pooled incidence of TE of 17.8% (95% CI: 9.9-27.4%), rising to 22.9% (95% CI: 14.5-32.4%) in patients admitted to intensive care (ICU). The most contemporary data are from a cohort of 1114 patients (715 outpatient, 399 hospitalised, 170 admitted to ICU). With robust COVID-19-specific therapies and widespread thromboprophylaxis the prevalence of venous TE in ICU patients was reported as 7% (n = 12) when catheter-/device-related events were excluded, and among the outpatients there was no TE reported. No published studies have used nationwide data to investigate TE during the pandemic or the effect of the pandemic on outcomes of patients with TE but without Covid-19. Added value of this study This retrospective multi-sourced nationwide unlinked cohort study compares the overall incidence and mortality of TE prior to and during the COVID-19 pandemic. We found an increased incidence of TE despite only a small proportion having a diagnosis of COVID-19. This may highlight the lack of testing, particularly in the community during the initial phase of the pandemic, and the possibility of other factors contributing to TE risk, such as decreased daily activity mandated by home quarantine and alterations in medication concordance. Mortality from TE was higher in the community during the pandemic and this highlights that adverse societal effects of the pandemic, such as aversion to seeking medical assessment, may precipitate worse outcomes related to TE. Implications of all the available evidence Evidence suggests that COVID-19 produces a hypercoagulable state and thromboprophylaxis is recommended in hospitalised patients to prevent excess mortality from TE. Whether to anticoagulate non-hospitalised ambulatory patients with COVID-19 will be answered by ongoing trials. Clinicians should consider the risks posed by decreased daily activity and fear of medical contact, and provide appropriate advice to patients.
AbstractBackgroundEvidence supports an excess of deaths during the COVID-19 pandemic. We report the incidence and mortality of thrombo-embolic events (TE) during the COVID-19 pandemic. MethodsMulti-sourced nationwide cohort study of adults (age ≥18 years) admitted to hospital with TE and deaths from TE in England (hospital and community) between 1st February 2018 and 31st July 2020. Relative risks, adjusted for age, sex, atrial fibrillation, co-morbidities and time trend comparing before and during the COVID-19 pandemic were estimated using Poisson regression. FindingsOf 268,054 patients admitted with TE to 195 hospitals, 82,208 (30.6%) were admitted after 2nd March 2020 (first COVID-19 death in the UK). The incidence of TE hospitalised increased during the COVID-19 pandemic from 1090 to 1517 per 100,000 (absolute risk change 45.9% [95% CI 45.1–46.6%], adjusted relative risk [ARR] 1.43 [95% CI 1.41–1.44]) driven particularly by pulmonary embolism; 1.49, 95% CI 1.46–1.52. TE were more frequent among those with COVID-19; 1.9% vs. 1.6%, absolute risk change 21.7%, 95% CI 21.0–22.4%, ARR 1.20, 95% CI 1.18–1.22. There was an increase in the overall mortality from TE during the pandemic (617, 6.7% proportional increase compared with the historical baseline), with more TE deaths occurring in the community compared with the historical rate (44% vs. 33%). InterpretationThe COVID-19 pandemic has resulted in an increase in the incidence of hospitalised TE. There were more deaths from TE in the community highlighting a number of mechanisms including the hypercoagulable state associated with COVID-19 infection and potential impact of delays in seeking help. Research in contextEvidence before this study We searched PubMed on 16 November 2020 for articles that documented the incidence and mortality of thrombo-embolic events (TE) during the COVID-19 pandemic using the search terms “COVID-19” OR “Coronavirus*” OR “2019-nCOV” OR “SARS-CoV” AND (“Thromboembolism” OR “Venous Thromboembolism” OR “thromboembol*”) with no language or time restrictions. The majority of data on TE in COVID-19 pertains to hospitalised patients from retrospective cohort studies. One study found that TE in hospitalised patients was associated with an increased mortality rate (adjusted hazard ratio 1.82; 95% CI 1.54–2.15). A systematic review and meta-analysis of 35 studies in 9249 hospitalised patients calculated an overall pooled incidence of TE of 17.8% (95% CI: 9.9–27.4%), rising to 22.9% (95% CI: 14.5–32.4%) in patients admitted to intensive care (ICU). The most contemporary data are from a cohort of 1114 patients (715 outpatient, 399 hospitalised, 170 admitted to ICU). With robust COVID-19-specific therapies and widespread thromboprophylaxis the prevalence of venous TE in ICU patients was reported as 7% ( n = 12) when catheter-/device-related events were excluded, and among the outpatients there was no TE reported. No published studies have used nationwide data to investigate TE during the pandemic or the effect of the pandemic on outcomes of patients with TE but without Covid-19. Added value of this study This retrospective multi-sourced nationwide unlinked cohort study compares the overall incidence and mortality of TE prior to and during the COVID-19 pandemic. We found an increased incidence of TE despite only a small proportion having a diagnosis of COVID-19. This may highlight the lack of testing, particularly in the community during the initial phase of the pandemic, and the possibility of other factors contributing to TE risk, such as decreased daily activity mandated by home quarantine and alterations in medication concordance. Mortality from TE was higher in the community during the pandemic and this highlights that adverse societal effects of the pandemic, such as aversion to seeking medical assessment, may precipitate worse outcomes related to TE. Implications of all the available evidence Evidence suggests that COVID-19 produces a hypercoagulable state and thromboprophylaxis is recommended in hospitalised patients to prevent excess mortality from TE. Whether to anticoagulate non-hospitalised ambulatory patients with COVID-19 will be answered by ongoing trials. Clinicians should consider the risks posed by decreased daily activity and fear of medical contact, and provide appropriate advice to patients.
Author Wu, Jianhua
Deanfield, John
Nadarajah, Ramesh
Gale, Chris P.
Aktaa, Suleman
de Belder, Mark
Rashid, Muhammad
Mamas, Mamas A.
Author_xml – sequence: 1
  givenname: Suleman
  surname: Aktaa
  fullname: Aktaa, Suleman
  email: s.aktaa@leeds.ac.uk
  organization: Leeds Institute for Data Analytics, University of Leeds, UK
– sequence: 2
  givenname: Jianhua
  surname: Wu
  fullname: Wu, Jianhua
  organization: Leeds Institute for Data Analytics, University of Leeds, UK
– sequence: 3
  givenname: Ramesh
  surname: Nadarajah
  fullname: Nadarajah, Ramesh
  organization: Leeds Institute for Data Analytics, University of Leeds, UK
– sequence: 4
  givenname: Muhammad
  surname: Rashid
  fullname: Rashid, Muhammad
  organization: Keele Cardiovascular Research Group, Centre for Prognosis Research, Institutes of Applied Clinical Science and Primary Care and Health Sciences, Keele University, UK
– sequence: 5
  givenname: Mark
  surname: de Belder
  fullname: de Belder, Mark
  organization: National Institute of Cardiovascular Outcomes Research (NICOR), Barts Health NHS Trust, UK
– sequence: 6
  givenname: John
  surname: Deanfield
  fullname: Deanfield, John
  organization: National Institute of Cardiovascular Outcomes Research (NICOR), Barts Health NHS Trust, UK
– sequence: 7
  givenname: Mamas A.
  surname: Mamas
  fullname: Mamas, Mamas A.
  organization: Keele Cardiovascular Research Group, Centre for Prognosis Research, Institutes of Applied Clinical Science and Primary Care and Health Sciences, Keele University, UK
– sequence: 8
  givenname: Chris P.
  surname: Gale
  fullname: Gale, Chris P.
  organization: Leeds Institute for Data Analytics, University of Leeds, UK
BackLink https://www.ncbi.nlm.nih.gov/pubmed/33711754$$D View this record in MEDLINE/PubMed
BookMark eNqNUstu1DAUjVARnRZ-ofKSTYIfSZwgVIGG10hFXfDYWo59p-PBsae2M9J8BP-Mp9NW0AVlYVnyPY_re-5JceS8g6I4I7gimLSv1lVaBT8GiBXFlFSYVRi3T4oZ6Xhf0prTo2KGcd2XrKu74-IkxjXGhJO-eVYcM8YJ4U09K34tnDIanAIknUajD0lak3ZIT4CSRzcug4d8rFEItuBSzMVg3FUuAppf_li8L0mPNpkPo1Gv0ZfJJlNGPwUFGm38ZrIyGe_KQcb8sAJp0woFUD7oiJRfZVMU06R3z4unS2kjvLi9T4vvHz98m38uLy4_LebvLkrV1jyV9VItCWZQSyq7BrhqVY-7oeFSsYGzRivVDRy6mg49ryld4lYPNYW2k3pglLPT4vygu5mGEbTKnwrSik0woww74aURf1ecWYkrvxW8Zx1vWBZ4eSsQ_PUEMYnRRAXWSgd-ioI2mNC2aXGXoWd_et2b3GWQAe0BoIKPMcDyHkKw2Ict1uIubLEPW2AmctiZ-OYBUZl0M-ncs7GP098e6JAnvTUQRFRmvwna5GyS0N48LnH-QEJZ44yS9ifsIK7zCricoyAiUoHF1_1C7veREoxxn4f5T4H_6eA3XZ34yg
CitedBy_id crossref_primary_10_1016_j_arbres_2022_03_011
crossref_primary_10_1186_s12931_021_01887_6
crossref_primary_10_3390_ijms25094941
crossref_primary_10_1042_BCJ20220154
crossref_primary_10_3389_fpsyg_2022_837365
crossref_primary_10_1016_j_thromres_2021_03_029
crossref_primary_10_1136_bmj_o817
crossref_primary_10_1186_s12884_021_03863_w
crossref_primary_10_3389_fphar_2022_849628
crossref_primary_10_1002_jmv_28646
crossref_primary_10_1183_13993003_02447_2022
crossref_primary_10_1016_j_jjcc_2021_09_010
crossref_primary_10_1080_17474086_2022_2080051
crossref_primary_10_1111_aas_70099
crossref_primary_10_1016_j_thromres_2022_02_008
crossref_primary_10_1016_j_ajoc_2022_101430
crossref_primary_10_1002_pul2_12113
crossref_primary_10_1016_j_ijid_2024_107155
crossref_primary_10_1016_S2213_2600_23_00159_5
crossref_primary_10_1016_j_thromres_2021_03_011
crossref_primary_10_3390_healthcare11060854
crossref_primary_10_1186_s40001_022_00655_6
crossref_primary_10_1016_j_ejphar_2023_175501
crossref_primary_10_1183_13993003_00619_2022
crossref_primary_10_5315_wjh_v10_i1_1
crossref_primary_10_1016_j_cpcardiol_2022_101186
crossref_primary_10_3389_fcvm_2021_715761
crossref_primary_10_1016_j_lanepe_2025_101433
crossref_primary_10_1371_journal_pone_0270195
crossref_primary_10_3390_jcm14061909
crossref_primary_10_1001_jamainternmed_2023_2461
crossref_primary_10_1016_j_amjms_2021_06_007
crossref_primary_10_1097_MD_0000000000034250
Cites_doi 10.1093/eurheartj/ehaa254
10.1136/bmj.m1931
10.1016/j.thromres.2020.08.022
10.1136/bmj.m1845
10.1136/heartjnl-2020-317912
10.1016/0021-9681(87)90171-8
10.1161/CIRCULATIONAHA.120.048020
10.1111/jth.15179
10.1002/ejhf.1916
10.1016/j.jacc.2020.08.070
10.1007/s00134-020-06062-x
10.1016/S2352-3026(20)30217-9
10.1016/j.jacc.2020.12.039
10.1056/NEJMc2015630
10.1093/eurheartj/ehaa623
10.1016/S0140-6736(20)31356-8
10.1136/bmj.m2295
10.1038/s41591-020-0968-3
10.1001/jama.2020.13372
10.1056/NEJMc2014816
10.1016/j.thromres.2020.06.010
10.1111/jth.14768
10.1056/NEJMoa2015432
10.1016/j.jacc.2020.03.031
10.1111/j.1538-7836.2007.02664.x
10.1056/NEJMc2009787
10.7326/M20-1495
10.1136/bmj.m2334
10.1038/s41584-020-0474-5
10.1016/S0140-6736(20)30566-3
10.1016/S0140-6736(20)30920-X
10.1016/j.thromres.2020.04.028
10.1161/CIRCULATIONAHA.120.047430
ContentType Journal Article
Copyright 2021 Elsevier Ltd
Copyright © 2021 Elsevier Ltd. All rights reserved.
2021 Elsevier Ltd. All rights reserved. 2021 Elsevier Ltd
Copyright_xml – notice: 2021 Elsevier Ltd
– notice: Copyright © 2021 Elsevier Ltd. All rights reserved.
– notice: 2021 Elsevier Ltd. All rights reserved. 2021 Elsevier Ltd
DBID AAYXX
CITATION
CGR
CUY
CVF
ECM
EIF
NPM
7X8
5PM
DOI 10.1016/j.thromres.2021.03.006
DatabaseName CrossRef
Medline
MEDLINE
MEDLINE (Ovid)
MEDLINE
MEDLINE
PubMed
MEDLINE - Academic
PubMed Central (Full Participant titles)
DatabaseTitle CrossRef
MEDLINE
Medline Complete
MEDLINE with Full Text
PubMed
MEDLINE (Ovid)
MEDLINE - Academic
DatabaseTitleList MEDLINE



MEDLINE - Academic

Database_xml – sequence: 1
  dbid: NPM
  name: PubMed
  url: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed
  sourceTypes: Index Database
– sequence: 2
  dbid: 7X8
  name: MEDLINE - Academic
  url: https://search.proquest.com/medline
  sourceTypes: Aggregation Database
DeliveryMethod fulltext_linktorsrc
Discipline Medicine
EISSN 1879-2472
EndPage 23
ExternalDocumentID PMC7938753
33711754
10_1016_j_thromres_2021_03_006
S0049384821000979
1_s2_0_S0049384821000979
Genre Meta-Analysis
Systematic Review
Journal Article
GeographicLocations England
GeographicLocations_xml – name: England
GroupedDBID ---
--K
--M
.1-
.55
.FO
.GJ
.~1
0R~
123
1B1
1P~
1RT
1~.
1~5
29Q
3O-
4.4
457
4CK
4G.
53G
5RE
5VS
7-5
71M
8P~
9JM
AABNK
AAEDT
AAEDW
AAIKJ
AAKOC
AALRI
AAOAW
AAQFI
AAQXK
AATTM
AAXKI
AAXUO
AAYWO
ABBQC
ABFNM
ABJNI
ABLJU
ABMAC
ABMZM
ABOCM
ABWVN
ABXDB
ACDAQ
ACGFS
ACIEU
ACIUM
ACLOT
ACRLP
ACRPL
ACVFH
ADBBV
ADCNI
ADEZE
ADMUD
ADNMO
ADVLN
AEBSH
AEIPS
AEKER
AENEX
AEUPX
AEVXI
AFFNX
AFJKZ
AFPUW
AFRHN
AFTJW
AFXIZ
AGHFR
AGQPQ
AGUBO
AGYEJ
AHHHB
AIEXJ
AIGII
AIIUN
AIKHN
AITUG
AJRQY
AJUYK
AKBMS
AKRWK
AKYEP
ALMA_UNASSIGNED_HOLDINGS
AMRAJ
ANKPU
ANZVX
APXCP
ASPBG
AVWKF
AXJTR
AZFZN
BKOJK
BLXMC
BNPGV
CS3
DU5
EBS
EFJIC
EFKBS
EFLBG
EJD
EO8
EO9
EP2
EP3
F5P
FDB
FEDTE
FGOYB
FIRID
FNPLU
FYGXN
G-2
G-Q
GBLVA
HEB
HMK
HMO
HVGLF
HZ~
IHE
J1W
J5H
K-O
KOM
L7B
M29
M41
MO0
N9A
O-L
O9-
OAUVE
OC~
OO-
OZT
P-8
P-9
PC.
Q38
R2-
ROL
RPZ
SAE
SCC
SDF
SDG
SDP
SEL
SES
SEW
SPCBC
SSH
SSZ
T5K
WUQ
X7M
Z5R
ZGI
~G-
~HD
0SF
AACTN
AFCTW
AFKWA
AJOXV
AMFUW
NCXOZ
RIG
9DU
AAYXX
CITATION
CGR
CUY
CVF
ECM
EIF
NPM
7X8
5PM
ID FETCH-LOGICAL-c647t-4fcf103e4a2a85e7c6c908b57ac3b735dcc8b7e842b97422f06db42e68adb3273
ISICitedReferencesCount 36
ISICitedReferencesURI http://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=Summon&SrcAuth=ProQuest&DestLinkType=CitingArticles&DestApp=WOS_CPL&KeyUT=000659438300004&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D
ISSN 0049-3848
1879-2472
IngestDate Tue Sep 30 15:00:38 EDT 2025
Sat Sep 27 16:58:22 EDT 2025
Thu Apr 03 07:06:38 EDT 2025
Tue Nov 18 21:40:31 EST 2025
Sat Nov 29 07:22:43 EST 2025
Sun Apr 06 06:53:53 EDT 2025
Tue Feb 25 19:58:29 EST 2025
Tue Oct 14 19:36:09 EDT 2025
IsDoiOpenAccess true
IsOpenAccess true
IsPeerReviewed true
IsScholarly true
Keywords COVID-19
Pulmonary embolism
Thrombo-embolic events
Mortality
Language English
License Copyright © 2021 Elsevier Ltd. All rights reserved.
Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
LinkModel OpenURL
MergedId FETCHMERGED-LOGICAL-c647t-4fcf103e4a2a85e7c6c908b57ac3b735dcc8b7e842b97422f06db42e68adb3273
Notes ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ObjectType-Undefined-3
OpenAccessLink https://pubmed.ncbi.nlm.nih.gov/PMC7938753
PMID 33711754
PQID 2501265608
PQPubID 23479
PageCount 7
ParticipantIDs pubmedcentral_primary_oai_pubmedcentral_nih_gov_7938753
proquest_miscellaneous_2501265608
pubmed_primary_33711754
crossref_primary_10_1016_j_thromres_2021_03_006
crossref_citationtrail_10_1016_j_thromres_2021_03_006
elsevier_sciencedirect_doi_10_1016_j_thromres_2021_03_006
elsevier_clinicalkeyesjournals_1_s2_0_S0049384821000979
elsevier_clinicalkey_doi_10_1016_j_thromres_2021_03_006
PublicationCentury 2000
PublicationDate 2021-06-01
PublicationDateYYYYMMDD 2021-06-01
PublicationDate_xml – month: 06
  year: 2021
  text: 2021-06-01
  day: 01
PublicationDecade 2020
PublicationPlace United States
PublicationPlace_xml – name: United States
PublicationTitle Thrombosis research
PublicationTitleAlternate Thromb Res
PublicationYear 2021
Publisher Elsevier Ltd
Publisher_xml – name: Elsevier Ltd
References Merrill, Erkan, Winakur, James (bb0035) 2020; 16
Gu, Tyagi, Jain (bb0105) 2020
Poissy, Goutay, Caplan (bb0120) 2020; 142
Wu, Mamas, Mohamed (bb0075) 2021; 107
Charlson, Pompei, Ales, MacKenzie (bb0090) 1987; 40
Gupta, Madhavan, Sehgal (bb0010) 2020; 26
bb0085
Kunutsor, Laukkanen (bb0130) 2020; 196
Helms, Tacquard, Severac (bb0145) 2020; 46
Raleigh (bb0185) 2020; 369
Kansagra, Goyal, Hamilton, Albers (bb0065) 2020; 383
Solomon, McNulty, Rana (bb0100) 2020; 383
Mafham, Spata, Goldacre (bb0070) 2020; 396
Wu, Mamas, de Belder, Deanfield, Gale (bb0080) 2021; 77
Nicolai L, Leunig A, Brambs S, et al. Vascular neutrophilic inflammation and immunothrombosis distinguish severe COVID-19 from influenza pneumonia. Journal of Thrombosis and Haemostasis; n/a(n/a).
Li, Liu, Zhang (bb0050) 2020; 395
Spyropoulos, Weitz (bb0005) 2020; 142
Driggin, Madhavan, Bikdeli (bb0015) 2020; 75
Bikdeli, Madhavan, Jimenez (bb0060) 2020; 75
Oliver (bb0155) 2020; 369
Benzakoun, Hmeydia, Delabarde (bb0180) 2020; 22
Liao, Zhou, Luo (bb0025) 2020; 7
Zhou, Yu, Du (bb0045) 2020; 395
Danzi, Loffi, Galeazzi, Gherbesi (bb0040) 2020; 41
Libby, Lüscher (bb0055) 2020; 41
Bilaloglu, Aphinyanaphongs, Jones, Iturrate, Hochman, Berger (bb0140) 2020; 324
Griffin (bb0160) 2020; 369
Piazza, Campia, Hurwitz (bb0030) 2020; 76
bb0190
Ackermann, Verleden, Kuehnel (bb0150) 2020; 383
Tang, Li, Wang, Sun (bb0020) 2020; 18
van Dam, Kroft, van der Wal (bb0115) 2020; 193
Wu, Mamas, Rashid (bb0095) 2020
Iacobucci (bb0165) 2020; 369
(bb0170) 2020; 173
Thomas, Varley, Johnston (bb0125) 2020; 191
Hitos, Cannon, Cannon, Garth, Fletcher (bb0175) 2007; 5
Oxley, Mocco, Majidi (bb0135) 2020; 382
Kunutsor (10.1016/j.thromres.2021.03.006_bb0130) 2020; 196
Wu (10.1016/j.thromres.2021.03.006_bb0095) 2020
Ackermann (10.1016/j.thromres.2021.03.006_bb0150) 2020; 383
Wu (10.1016/j.thromres.2021.03.006_bb0080) 2021; 77
Oliver (10.1016/j.thromres.2021.03.006_bb0155) 2020; 369
Griffin (10.1016/j.thromres.2021.03.006_bb0160) 2020; 369
10.1016/j.thromres.2021.03.006_bb0110
Li (10.1016/j.thromres.2021.03.006_bb0050) 2020; 395
Charlson (10.1016/j.thromres.2021.03.006_bb0090) 1987; 40
Piazza (10.1016/j.thromres.2021.03.006_bb0030) 2020; 76
Thomas (10.1016/j.thromres.2021.03.006_bb0125) 2020; 191
Raleigh (10.1016/j.thromres.2021.03.006_bb0185) 2020; 369
Solomon (10.1016/j.thromres.2021.03.006_bb0100) 2020; 383
Gupta (10.1016/j.thromres.2021.03.006_bb0010) 2020; 26
(10.1016/j.thromres.2021.03.006_bb0170) 2020; 173
Liao (10.1016/j.thromres.2021.03.006_bb0025) 2020; 7
Merrill (10.1016/j.thromres.2021.03.006_bb0035) 2020; 16
Iacobucci (10.1016/j.thromres.2021.03.006_bb0165) 2020; 369
Libby (10.1016/j.thromres.2021.03.006_bb0055) 2020; 41
Helms (10.1016/j.thromres.2021.03.006_bb0145) 2020; 46
Hitos (10.1016/j.thromres.2021.03.006_bb0175) 2007; 5
Driggin (10.1016/j.thromres.2021.03.006_bb0015) 2020; 75
Bikdeli (10.1016/j.thromres.2021.03.006_bb0060) 2020; 75
Oxley (10.1016/j.thromres.2021.03.006_bb0135) 2020; 382
Benzakoun (10.1016/j.thromres.2021.03.006_bb0180) 2020; 22
Poissy (10.1016/j.thromres.2021.03.006_bb0120) 2020; 142
Danzi (10.1016/j.thromres.2021.03.006_bb0040) 2020; 41
Tang (10.1016/j.thromres.2021.03.006_bb0020) 2020; 18
Kansagra (10.1016/j.thromres.2021.03.006_bb0065) 2020; 383
Zhou (10.1016/j.thromres.2021.03.006_bb0045) 2020; 395
Mafham (10.1016/j.thromres.2021.03.006_bb0070) 2020; 396
van Dam (10.1016/j.thromres.2021.03.006_bb0115) 2020; 193
Spyropoulos (10.1016/j.thromres.2021.03.006_bb0005) 2020; 142
Wu (10.1016/j.thromres.2021.03.006_bb0075) 2021; 107
Bilaloglu (10.1016/j.thromres.2021.03.006_bb0140) 2020; 324
Gu (10.1016/j.thromres.2021.03.006_bb0105) 2020
References_xml – volume: 196
  start-page: 27
  year: 2020
  end-page: 30
  ident: bb0130
  article-title: Incidence of venous and arterial thromboembolic complications in COVID-19: a systematic review and meta-analysis
  publication-title: Thromb. Res.
– volume: 383
  start-page: 120
  year: 2020
  end-page: 128
  ident: bb0150
  article-title: Pulmonary vascular endothelialitis, thrombosis, and angiogenesis in Covid-19
  publication-title: N. Engl. J. Med.
– volume: 41
  start-page: 1858
  year: 2020
  ident: bb0040
  article-title: Acute pulmonary embolism and COVID-19 pneumonia: a random association?
  publication-title: European Heart Journal
– volume: 142
  start-page: 184
  year: 2020
  end-page: 186
  ident: bb0120
  article-title: Pulmonary embolism in patients with COVID-19
  publication-title: Circulation
– volume: 383
  start-page: 691
  year: 2020
  end-page: 693
  ident: bb0100
  article-title: The Covid-19 pandemic and the incidence of acute myocardial infarction
  publication-title: N. Engl. J. Med.
– volume: 40
  start-page: 373
  year: 1987
  end-page: 383
  ident: bb0090
  article-title: A new method of classifying prognostic comorbidity in longitudinal studies: development and validation
  publication-title: J. Chronic Dis.
– volume: 18
  start-page: 844
  year: 2020
  end-page: 847
  ident: bb0020
  article-title: Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia
  publication-title: J. Thromb. Haemost.
– volume: 107
  start-page: 113
  year: 2021
  end-page: 119
  ident: bb0075
  article-title: Place and causes of acute cardiovascular mortality during the COVID-19 pandemic
  publication-title: Heart
– volume: 383
  start-page: 400
  year: 2020
  end-page: 401
  ident: bb0065
  article-title: Collateral effect of Covid-19 on stroke evaluation in the United States
  publication-title: N. Engl. J. Med.
– volume: 396
  start-page: 381
  year: 2020
  end-page: 389
  ident: bb0070
  article-title: COVID-19 pandemic and admission rates for and management of acute coronary syndromes in England
  publication-title: Lancet
– volume: 369
  start-page: m2295
  year: 2020
  ident: bb0185
  article-title: Tackling UK’s mortality problem: covid-19 and other causes
  publication-title: BMJ
– volume: 75
  start-page: 2950
  year: 2020
  end-page: 2973
  ident: bb0060
  article-title: COVID-19 and thrombotic or thromboembolic disease: implications for prevention, antithrombotic therapy, and follow-up. <span class=“subtitle”><em>JACC</em> State-of-the-Art Review</span>
– reference: Nicolai L, Leunig A, Brambs S, et al. Vascular neutrophilic inflammation and immunothrombosis distinguish severe COVID-19 from influenza pneumonia. Journal of Thrombosis and Haemostasis; n/a(n/a).
– ident: bb0085
  article-title: User guide to mortality statistics
– volume: 173
  start-page: 262
  year: 2020
  end-page: 267
  ident: bb0170
  article-title: Variation in false-negative rate of reverse transcriptase polymerase chain reaction–based SARS-CoV-2 tests by time since exposure
  publication-title: Annals of Internal Medicine
– volume: 7
  year: 2020
  ident: bb0025
  article-title: Haematological characteristics and risk factors in the classification and prognosis evaluation of COVID-19: a retrospective cohort study
  publication-title: The Lancet Haematology
– volume: 77
  start-page: 1141
  year: 2021
  end-page: 1143
  ident: bb0080
  article-title: Second decline in admissions with heart failure and myocardial infarction during the COVID-19 pandemic
  publication-title: J. Am. Coll. Cardiol.
– volume: 395
  start-page: 1517
  year: 2020
  end-page: 1520
  ident: bb0050
  article-title: SARS-CoV-2 and viral sepsis: observations and hypotheses
  publication-title: Lancet
– volume: 16
  start-page: 581
  year: 2020
  end-page: 589
  ident: bb0035
  article-title: Emerging evidence of a COVID-19 thrombotic syndrome has treatment implications
  publication-title: Nat. Rev. Rheumatol.
– volume: 76
  start-page: 2060
  year: 2020
  end-page: 2072
  ident: bb0030
  article-title: Registry of arterial and venous thromboembolic complications in patients with COVID-19
  publication-title: J. Am. Coll. Cardiol.
– volume: 41
  start-page: 3038
  year: 2020
  end-page: 3044
  ident: bb0055
  article-title: COVID-19 is, in the end, an endothelial disease
  publication-title: Eur. Heart J.
– start-page: 1
  year: 2020
  end-page: 16
  ident: bb0105
  article-title: Thrombocytopathy and endotheliopathy: crucial contributors to COVID-19 thromboinflammation
  publication-title: Nat. Rev. Cardiol.
– volume: 26
  start-page: 1017
  year: 2020
  end-page: 1032
  ident: bb0010
  article-title: Extrapulmonary manifestations of COVID-19
  publication-title: Nat. Med.
– volume: 395
  start-page: 1054
  year: 2020
  end-page: 1062
  ident: bb0045
  article-title: Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study
  publication-title: Lancet
– volume: 46
  start-page: 1089
  year: 2020
  end-page: 1098
  ident: bb0145
  article-title: High risk of thrombosis in patients with severe SARS-CoV-2 infection: a multicenter prospective cohort study
  publication-title: Intensive Care Med.
– volume: 75
  start-page: 2352
  year: 2020
  end-page: 2371
  ident: bb0015
  article-title: Cardiovascular considerations for patients, health care workers, and health systems during the COVID-19 pandemic
  publication-title: J. Am. Coll. Cardiol.
– volume: 193
  start-page: 86
  year: 2020
  end-page: 89
  ident: bb0115
  article-title: Clinical and computed tomography characteristics of COVID-19 associated acute pulmonary embolism: a different phenotype of thrombotic disease?
  publication-title: Thromb. Res.
– volume: 324
  start-page: 799
  year: 2020
  end-page: 801
  ident: bb0140
  article-title: Thrombosis in hospitalized patients with COVID-19 in a New York City health system
  publication-title: JAMA
– start-page: 1
  year: 2020
  end-page: 9
  ident: bb0095
  article-title: Patient response, treatments, and mortality for acute myocardial infarction during the COVID-19 pandemic
  publication-title: European Heart Journal - Quality of Care and Clinical Outcomes
– volume: 369
  start-page: m1845
  year: 2020
  ident: bb0165
  article-title: Covid-19: lack of capacity led to halting of community testing in march, admits deputy chief medical officer
  publication-title: BMJ
– volume: 382
  year: 2020
  ident: bb0135
  article-title: Large-vessel stroke as a presenting feature of Covid-19 in the young
  publication-title: N. Engl. J. Med.
– volume: 369
  start-page: m2334
  year: 2020
  ident: bb0155
  article-title: David Oliver: Let’s be open and honest about covid-19 deaths in care homes
  publication-title: BMJ
– volume: 22
  start-page: 1046
  year: 2020
  end-page: 1047
  ident: bb0180
  article-title: Excess out-of-hospital deaths during the COVID-19 outbreak: evidence of pulmonary embolism as a main determinant
  publication-title: Eur. J. Heart Fail.
– volume: 369
  start-page: m1931
  year: 2020
  ident: bb0160
  article-title: Covid-19: “staggering number” of extra deaths in community is not explained by covid-19
  publication-title: BMJ
– volume: 5
  start-page: 1890
  year: 2007
  end-page: 1895
  ident: bb0175
  article-title: Effect of leg exercises on popliteal venous blood flow during prolonged immobility of seated subjects: implications for prevention of travel-related deep vein thrombosis
  publication-title: J. Thromb. Haemost.
– volume: 191
  start-page: 76
  year: 2020
  end-page: 77
  ident: bb0125
  article-title: Thrombotic complications of patients admitted to intensive care with COVID-19 at a teaching hospital in the United Kingdom
  publication-title: Thromb. Res.
– ident: bb0190
  article-title: Guidance for doctors completing medical certificates of cause of death in England and Wales
– volume: 142
  start-page: 129
  year: 2020
  end-page: 132
  ident: bb0005
  article-title: Hospitalized COVID-19 patients and venous thromboembolism
  publication-title: Circulation
– volume: 41
  start-page: 1858
  issue: 19
  year: 2020
  ident: 10.1016/j.thromres.2021.03.006_bb0040
  article-title: Acute pulmonary embolism and COVID-19 pneumonia: a random association?
  publication-title: European Heart Journal
  doi: 10.1093/eurheartj/ehaa254
– volume: 369
  start-page: m1931
  year: 2020
  ident: 10.1016/j.thromres.2021.03.006_bb0160
  article-title: Covid-19: “staggering number” of extra deaths in community is not explained by covid-19
  publication-title: BMJ
  doi: 10.1136/bmj.m1931
– volume: 196
  start-page: 27
  year: 2020
  ident: 10.1016/j.thromres.2021.03.006_bb0130
  article-title: Incidence of venous and arterial thromboembolic complications in COVID-19: a systematic review and meta-analysis
  publication-title: Thromb. Res.
  doi: 10.1016/j.thromres.2020.08.022
– volume: 369
  start-page: m1845
  year: 2020
  ident: 10.1016/j.thromres.2021.03.006_bb0165
  article-title: Covid-19: lack of capacity led to halting of community testing in march, admits deputy chief medical officer
  publication-title: BMJ
  doi: 10.1136/bmj.m1845
– volume: 107
  start-page: 113
  year: 2021
  ident: 10.1016/j.thromres.2021.03.006_bb0075
  article-title: Place and causes of acute cardiovascular mortality during the COVID-19 pandemic
  publication-title: Heart
  doi: 10.1136/heartjnl-2020-317912
– volume: 40
  start-page: 373
  issue: 5
  year: 1987
  ident: 10.1016/j.thromres.2021.03.006_bb0090
  article-title: A new method of classifying prognostic comorbidity in longitudinal studies: development and validation
  publication-title: J. Chronic Dis.
  doi: 10.1016/0021-9681(87)90171-8
– volume: 142
  start-page: 129
  issue: 2
  year: 2020
  ident: 10.1016/j.thromres.2021.03.006_bb0005
  article-title: Hospitalized COVID-19 patients and venous thromboembolism
  publication-title: Circulation
  doi: 10.1161/CIRCULATIONAHA.120.048020
– ident: 10.1016/j.thromres.2021.03.006_bb0110
  doi: 10.1111/jth.15179
– volume: 22
  start-page: 1046
  issue: 6
  year: 2020
  ident: 10.1016/j.thromres.2021.03.006_bb0180
  article-title: Excess out-of-hospital deaths during the COVID-19 outbreak: evidence of pulmonary embolism as a main determinant
  publication-title: Eur. J. Heart Fail.
  doi: 10.1002/ejhf.1916
– volume: 76
  start-page: 2060
  issue: 18
  year: 2020
  ident: 10.1016/j.thromres.2021.03.006_bb0030
  article-title: Registry of arterial and venous thromboembolic complications in patients with COVID-19
  publication-title: J. Am. Coll. Cardiol.
  doi: 10.1016/j.jacc.2020.08.070
– volume: 46
  start-page: 1089
  issue: 6
  year: 2020
  ident: 10.1016/j.thromres.2021.03.006_bb0145
  article-title: High risk of thrombosis in patients with severe SARS-CoV-2 infection: a multicenter prospective cohort study
  publication-title: Intensive Care Med.
  doi: 10.1007/s00134-020-06062-x
– volume: 7
  issue: 9
  year: 2020
  ident: 10.1016/j.thromres.2021.03.006_bb0025
  article-title: Haematological characteristics and risk factors in the classification and prognosis evaluation of COVID-19: a retrospective cohort study
  publication-title: The Lancet Haematology
  doi: 10.1016/S2352-3026(20)30217-9
– volume: 77
  start-page: 1141
  issue: 8
  year: 2021
  ident: 10.1016/j.thromres.2021.03.006_bb0080
  article-title: Second decline in admissions with heart failure and myocardial infarction during the COVID-19 pandemic
  publication-title: J. Am. Coll. Cardiol.
  doi: 10.1016/j.jacc.2020.12.039
– volume: 383
  start-page: 691
  issue: 7
  year: 2020
  ident: 10.1016/j.thromres.2021.03.006_bb0100
  article-title: The Covid-19 pandemic and the incidence of acute myocardial infarction
  publication-title: N. Engl. J. Med.
  doi: 10.1056/NEJMc2015630
– volume: 41
  start-page: 3038
  issue: 32
  year: 2020
  ident: 10.1016/j.thromres.2021.03.006_bb0055
  article-title: COVID-19 is, in the end, an endothelial disease
  publication-title: Eur. Heart J.
  doi: 10.1093/eurheartj/ehaa623
– volume: 396
  start-page: 381
  issue: 10248
  year: 2020
  ident: 10.1016/j.thromres.2021.03.006_bb0070
  article-title: COVID-19 pandemic and admission rates for and management of acute coronary syndromes in England
  publication-title: Lancet
  doi: 10.1016/S0140-6736(20)31356-8
– volume: 369
  start-page: m2295
  year: 2020
  ident: 10.1016/j.thromres.2021.03.006_bb0185
  article-title: Tackling UK’s mortality problem: covid-19 and other causes
  publication-title: BMJ
  doi: 10.1136/bmj.m2295
– volume: 26
  start-page: 1017
  issue: 7
  year: 2020
  ident: 10.1016/j.thromres.2021.03.006_bb0010
  article-title: Extrapulmonary manifestations of COVID-19
  publication-title: Nat. Med.
  doi: 10.1038/s41591-020-0968-3
– volume: 324
  start-page: 799
  issue: 8
  year: 2020
  ident: 10.1016/j.thromres.2021.03.006_bb0140
  article-title: Thrombosis in hospitalized patients with COVID-19 in a New York City health system
  publication-title: JAMA
  doi: 10.1001/jama.2020.13372
– volume: 383
  start-page: 400
  issue: 4
  year: 2020
  ident: 10.1016/j.thromres.2021.03.006_bb0065
  article-title: Collateral effect of Covid-19 on stroke evaluation in the United States
  publication-title: N. Engl. J. Med.
  doi: 10.1056/NEJMc2014816
– volume: 75
  start-page: 2950
  issue: 23
  year: 2020
  ident: 10.1016/j.thromres.2021.03.006_bb0060
  article-title: COVID-19 and thrombotic or thromboembolic disease: implications for prevention, antithrombotic therapy, and follow-up. <span class=“subtitle”>JACC State-of-the-Art Review</span>
– start-page: 1
  year: 2020
  ident: 10.1016/j.thromres.2021.03.006_bb0105
  article-title: Thrombocytopathy and endotheliopathy: crucial contributors to COVID-19 thromboinflammation
  publication-title: Nat. Rev. Cardiol.
– volume: 193
  start-page: 86
  year: 2020
  ident: 10.1016/j.thromres.2021.03.006_bb0115
  article-title: Clinical and computed tomography characteristics of COVID-19 associated acute pulmonary embolism: a different phenotype of thrombotic disease?
  publication-title: Thromb. Res.
  doi: 10.1016/j.thromres.2020.06.010
– volume: 18
  start-page: 844
  issue: 4
  year: 2020
  ident: 10.1016/j.thromres.2021.03.006_bb0020
  article-title: Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia
  publication-title: J. Thromb. Haemost.
  doi: 10.1111/jth.14768
– volume: 383
  start-page: 120
  issue: 2
  year: 2020
  ident: 10.1016/j.thromres.2021.03.006_bb0150
  article-title: Pulmonary vascular endothelialitis, thrombosis, and angiogenesis in Covid-19
  publication-title: N. Engl. J. Med.
  doi: 10.1056/NEJMoa2015432
– volume: 75
  start-page: 2352
  issue: 18
  year: 2020
  ident: 10.1016/j.thromres.2021.03.006_bb0015
  article-title: Cardiovascular considerations for patients, health care workers, and health systems during the COVID-19 pandemic
  publication-title: J. Am. Coll. Cardiol.
  doi: 10.1016/j.jacc.2020.03.031
– volume: 5
  start-page: 1890
  issue: 9
  year: 2007
  ident: 10.1016/j.thromres.2021.03.006_bb0175
  article-title: Effect of leg exercises on popliteal venous blood flow during prolonged immobility of seated subjects: implications for prevention of travel-related deep vein thrombosis
  publication-title: J. Thromb. Haemost.
  doi: 10.1111/j.1538-7836.2007.02664.x
– volume: 382
  issue: 20
  year: 2020
  ident: 10.1016/j.thromres.2021.03.006_bb0135
  article-title: Large-vessel stroke as a presenting feature of Covid-19 in the young
  publication-title: N. Engl. J. Med.
  doi: 10.1056/NEJMc2009787
– volume: 173
  start-page: 262
  issue: 4
  year: 2020
  ident: 10.1016/j.thromres.2021.03.006_bb0170
  article-title: Variation in false-negative rate of reverse transcriptase polymerase chain reaction–based SARS-CoV-2 tests by time since exposure
  publication-title: Annals of Internal Medicine
  doi: 10.7326/M20-1495
– volume: 369
  start-page: m2334
  year: 2020
  ident: 10.1016/j.thromres.2021.03.006_bb0155
  article-title: David Oliver: Let’s be open and honest about covid-19 deaths in care homes
  publication-title: BMJ
  doi: 10.1136/bmj.m2334
– volume: 16
  start-page: 581
  issue: 10
  year: 2020
  ident: 10.1016/j.thromres.2021.03.006_bb0035
  article-title: Emerging evidence of a COVID-19 thrombotic syndrome has treatment implications
  publication-title: Nat. Rev. Rheumatol.
  doi: 10.1038/s41584-020-0474-5
– volume: 395
  start-page: 1054
  issue: 10229
  year: 2020
  ident: 10.1016/j.thromres.2021.03.006_bb0045
  article-title: Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study
  publication-title: Lancet
  doi: 10.1016/S0140-6736(20)30566-3
– volume: 395
  start-page: 1517
  issue: 10235
  year: 2020
  ident: 10.1016/j.thromres.2021.03.006_bb0050
  article-title: SARS-CoV-2 and viral sepsis: observations and hypotheses
  publication-title: Lancet
  doi: 10.1016/S0140-6736(20)30920-X
– start-page: 1
  year: 2020
  ident: 10.1016/j.thromres.2021.03.006_bb0095
  article-title: Patient response, treatments, and mortality for acute myocardial infarction during the COVID-19 pandemic
  publication-title: European Heart Journal - Quality of Care and Clinical Outcomes
– volume: 191
  start-page: 76
  year: 2020
  ident: 10.1016/j.thromres.2021.03.006_bb0125
  article-title: Thrombotic complications of patients admitted to intensive care with COVID-19 at a teaching hospital in the United Kingdom
  publication-title: Thromb. Res.
  doi: 10.1016/j.thromres.2020.04.028
– volume: 142
  start-page: 184
  issue: 2
  year: 2020
  ident: 10.1016/j.thromres.2021.03.006_bb0120
  article-title: Pulmonary embolism in patients with COVID-19
  publication-title: Circulation
  doi: 10.1161/CIRCULATIONAHA.120.047430
SSID ssj0017195
Score 2.5012848
SecondaryResourceType review_article
Snippet Evidence supports an excess of deaths during the COVID-19 pandemic. We report the incidence and mortality of thrombo-embolic events (TE) during the COVID-19...
AbstractBackgroundEvidence supports an excess of deaths during the COVID-19 pandemic. We report the incidence and mortality of thrombo-embolic events (TE)...
Unlabelled Image
SourceID pubmedcentral
proquest
pubmed
crossref
elsevier
SourceType Open Access Repository
Aggregation Database
Index Database
Enrichment Source
Publisher
StartPage 17
SubjectTerms Adolescent
Adult
Anticoagulants
Cohort Studies
COVID-19
England - epidemiology
Hematology, Oncology, and Palliative Medicine
Humans
Incidence
Mortality
Pandemics
Pulmonary embolism
Retrospective Studies
SARS-CoV-2
Thrombo-embolic events
Venous Thromboembolism
Title Incidence and mortality due to thromboembolic events during the COVID-19 pandemic: Multi-sourced population-based health records cohort study
URI https://www.clinicalkey.com/#!/content/1-s2.0-S0049384821000979
https://www.clinicalkey.es/playcontent/1-s2.0-S0049384821000979
https://dx.doi.org/10.1016/j.thromres.2021.03.006
https://www.ncbi.nlm.nih.gov/pubmed/33711754
https://www.proquest.com/docview/2501265608
https://pubmed.ncbi.nlm.nih.gov/PMC7938753
Volume 202
WOSCitedRecordID wos000659438300004&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D
hasFullText 1
inHoldings 1
isFullTextHit
isPrint
journalDatabaseRights – providerCode: PRVESC
  databaseName: Elsevier SD Freedom Collection Journals 2021
  customDbUrl:
  eissn: 1879-2472
  dateEnd: 99991231
  omitProxy: false
  ssIdentifier: ssj0017195
  issn: 0049-3848
  databaseCode: AIEXJ
  dateStart: 20160601
  isFulltext: true
  titleUrlDefault: https://www.sciencedirect.com
  providerName: Elsevier
link http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwtV1bb9MwFLa6DSFeEHfKZTISb1VK4iS1w9tUihiXgsaAvll24qgtbVo1ybQ_wb_gh3Icx1m7bmJM4qFRldiO4_PZPj72-Q5CLxMVEljfCEcqGTgBIxF0KdZzhJ_60vWkF8ZV1JKPdDhko1H0pdX6bX1hTmY0y9jpabT8r6KGeyBs7Tr7D-JuCoUb8B-EDlcQO1yvJHjo8SZQaLUvMK_Ua61qJ6UyiuZqMZcLBT_Nb10ROOXWW1Frof3P3w_fOF7UWWr78nyiv6xT-ek6xtKfdJZN1C9Hz4JJ7U3ZMRafvKOj7q6KNeraqcVk9W7NgVKTDDXG6IOfhRDmmNBMzc8g-6OscAYgHpfNDDIUiViJqahMQkf6nG9TzpEODmUCJZdjMZ-LZN2uQdbOX9mxOogcnxkezq2B3tgcpt2q0aDKXV2Eoau9gFl70P_gOTnpus5XXawulXiVD0u0mdisi3hOuMu3ku6gPULDCMbOvYPDweh9s1tFvchEyqhrvOaJfnENL1OCthc558_qrik_x3fQ7XrVgg8M2u6ilsruoZuf6nMZ99GvBnQYQIMb0GEAHS4WeBN02IAOG9DBQ4Ut6LAF3Wu8ATl8HnLYQA7XkMMGcriC3AP07e3guP_OqQN9OHEvoIUTpHHqub4KBBEsVDTuxZHLZEhF7Evqh0kcM0kVC4iE5S8hqdtLZEBUj4lE-qCAP0S72SJTjxFOaJgKKVIVkzQgAY0kCwlMpAr0dEZo0kahbXke1yz4OhjLjNvjjlNuJca1xLjrc5BYG71q8i0ND8xfc1ArWG69nGFe5oDg6-VUeT3K5PwyhLZR1OSsNWijGV_prS8s-jhMMXrfUGRqUUKiELRYTdLF2uiRQWPTBr5PNdlvAHXewGmTQNPXbz7JJuOKxh40A20seXLtr32Kbp0NHM_QbrEq1XN0Iz4pJvlqH-3QEduvu-ofOQYbcw
linkProvider Elsevier
openUrl ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Incidence+and+mortality+due+to+thromboembolic+events+during+the+COVID-19+pandemic%3A+Multi-sourced+population-based+health+records+cohort+study&rft.jtitle=Thrombosis+research&rft.au=Aktaa%2C+Suleman&rft.au=Wu%2C+Jianhua&rft.au=Nadarajah%2C+Ramesh&rft.au=Rashid%2C+Muhammad&rft.date=2021-06-01&rft.issn=0049-3848&rft_id=info:doi/10.1016%2Fj.thromres.2021.03.006&rft.externalDBID=ECK1-s2.0-S0049384821000979&rft.externalDocID=1_s2_0_S0049384821000979
thumbnail_l http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0049-3848&client=summon
thumbnail_m http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0049-3848&client=summon
thumbnail_s http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0049-3848&client=summon