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Coagulation Disorders

Thrombosis in Hospitalized Patients With COVID-19 in a New York City Health System

Educational Objective
To understand the risks of thrombosis in hospitalized patients with COVID-19

1 Credit CME

JAMA

Published Online: July 20, 2020

Research Letter

Article Information and Disclosures

Seda Bilaloglu, MS¹;

Yin Aphinyanaphongs, MD, PhD¹;

Simon Jones, PhD, MSc¹;

Eduardo Iturrate, MD, MSW²;

Judith Hochman, MD²;

Jeffrey S. Berger, MD, MS²

Author Affiliations

¹Department of Population Health, New York University Langone Health, New York, New York
²Department of Medicine, New York University Langone Health, New York, New York

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Original Investigation

Clinical Characteristics, Comorbidities, and Outcomes Among Patients With COVID-19 Hospitalized in the NYC Area

Safiya Richardson, MD, MPH; Jamie S. Hirsch, MD, MA, MSB; Mangala Narasimhan, DO; James M. Crawford, MD, PhD; Thomas McGinn, MD, MPH; Karina W. Davidson, PhD, MASc; and the Northwell COVID-19 Research Consortium; Douglas P. Barnaby, MD, MSc; Lance B. Becker, MD; John D. Chelico, MD, MA; Stuart L. Cohen, MD; Jennifer Cookingham, MHA; Kevin Coppa, BS; Michael A. Diefenbach, PhD; Andrew J. Dominello, BA; Joan Duer-Hefele, RN, MA; Louise Falzon, BA, PGDipInf; Jordan Gitlin, MD; Negin Hajizadeh, MD, MPH; Tiffany G. Harvin, MBA; David A. Hirschwerk, MD; Eun Ji Kim, MD, MS, MS; Zachary M. Kozel, MD; Lyndonna M. Marrast, MD, MPH; Jazmin N. Mogavero, MA; Gabrielle A. Osorio, MPH; Michael Qiu, MD, PhD; Theodoros P. Zanos, PhD
Original Investigation

Factors Associated With Surgical Mortality and Complications Among Patients With and Without COVID-19 in Italy

Francesco Doglietto, MD, PhD; Marika Vezzoli, PhD; Federico Gheza, MD; Gian Luca Lussardi, MD; Marco Domenicucci, MD; Luca Vecchiarelli, MD; Luca Zanin, MD; Giorgio Saraceno, MD; Liana Signorini, MD; Pier Paolo Panciani, MD, PhD; Francesco Castelli, MD; Roberto Maroldi, MD; Francesco Antonio Rasulo, MD; Mauro Roberto Benvenuti, MD; Nazario Portolani, MD; Stefano Bonardelli, MD; Giuseppe Milano, MD; Alessandro Casiraghi, MD; Stefano Calza, PhD; Marco Maria Fontanella, MD
Research Letter

Prevalence of SARS-CoV-2 Antibodies in Health Care Personnel in the New York City Area

Joseph Moscola, PA, MBA; Grace Sembajwe, DSc, MSc, CIH; Mark Jarrett, MD, MBA, MS; Bruce Farber, MD; Tylis Chang, MD; Thomas McGinn, MD, MPH; Karina W. Davidson, PhD, MASc; Northwell Health COVID-19 Research Consortium
Original Investigation

Out-of-Hospital Cardiac Arrests and Resuscitations During COVID-19 Pandemic

Pamela H. Lai, MD, PhD, MSc; Elizabeth A. Lancet, DrPH, MPH; Michael D. Weiden, MS, MD; Mayris P. Webber, DrPH, MPH; Rachel Zeig-Owens, DrPH, MPH; Charles B. Hall, PhD; David J. Prezant, MD
Original Investigation

Risk of Ischemic Stroke in Patients With Coronavirus Disease 2019 (COVID-19) vs Patients With Influenza

Alexander E. Merkler, MD; Neal S. Parikh, MD, MS; Saad Mir, MD; Ajay Gupta, MD, MS; Hooman Kamel, MD, MS; Eaton Lin, MD; Joshua Lantos, MD; Edward J. Schenck, MD; Parag Goyal, MD; Samuel S. Bruce, MD, MA; Joshua Kahan, MBBS, PhD; Kelsey N. Lansdale, BA; Natalie M. LeMoss, BS; Santosh B. Murthy, MD, MPH; Philip E. Stieg, PhD, MD; Matthew E. Fink, MD; Costantino Iadecola, MD; Alan Z. Segal, MD; Marika Cusick, MS; Thomas R. Campion Jr, PhD, MS; Ivan Diaz, PhD; Cenai Zhang, MS; Babak B. Navi, MD, MS
JAMA Insights

Diagnosis, Management, and Pathophysiology of Arterial and Venous Thrombosis in COVID-19

Gregory Piazza, MD, MS; David A. Morrow, MD, MPH

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Patients with coronavirus disease 2019 (COVID-19) are at increased risk of thrombosis.¹ However, studies have been limited in size, did not report all thrombotic events, and focused on patients with severe disease hospitalized in intensive care units (ICUs). We assessed the incidence of, and risk factors for, venous and arterial thrombotic events in all hospitalized patients with COVID-19 at a large health system consisting of 4 hospitals in New York City.

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Article Information

Corresponding Author: Jeffrey S. Berger, MD, MS, Center for the Prevention of Cardiovascular Disease, New York University School of Medicine, 530 First Ave, Skirball 9R, New York, NY 10016 (jeffrey.berger@nyulangone.org).

Accepted for Publication: July 8, 2020.

Published Online: July 20, 2020. doi:10.1001/jama.2020.13372

Correction: This article was corrected on July 29, 2020, to fix the hazard ratios for male sex and current smoker in Table 2.

Author Contributions: Dr Berger had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Bilaloglu, Iturrate, Hochman, Berger.

Acquisition, analysis, or interpretation of data: Bilaloglu, Aphinyanaphongs, Jones, Iturrate.

Drafting of the manuscript: Bilaloglu, Iturrate, Berger.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Bilaloglu, Jones.

Administrative, technical, or material support: Bilaloglu, Iturrate, Berger.

Supervision: All authors.

Conflict of Interest Disclosures: Dr Hochman reported receiving support for drug distribution related to the ISCHEMIA Trial and in-kind donations for participating sites from AstraZeneca Pharmaceuticals and Arbor Pharmaceuticals; in-kind donations for participating sites from Abbott Vascular, Medtronic Inc, St Jude Medical Inc, Volcano Corp, Merck Sharp & Dohme Corp, Omron Healthcare Inc, and Amgen Inc; and grants from the National Heart, Lung, and Blood Institute for serving as chair of the ISCHEMIA study. Dr Berger reported receiving grants from AstraZeneca, personal fees from Janssen, and personal fees from Amgen outside the submitted work. No other disclosures were reported.

Funding/Support: Funding for this project was supported in part by New York University (NYU) CTSA grant UL1TR001445 from the National Center for Advancing Translational Sciences. Dr Berger is funded in part by the National Heart, Lung, and Blood Institute (grants R01HL139909 and R35HL144993).

Role of the Funder/Sponsor: The funding agencies had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Additional Contributions: We acknowledge Meng Cao, BSE, Siddhant Dogra, BS, Ruina Zhang, AB, and Emma Simon, BS, who reviewed the clinical charts, and Ji Chen, MS, who queried data, all from the NYU Grossman School of Medicine. There was no financial compensation for these contributions.

References

Connors JM , Levy JH . COVID-19 and its implications for thrombosis and anticoagulation. Blood. 2020;135(23):2033-2040. doi:10.1182/blood.2020006000 PubMed Google Scholar Crossref

Swartz J , Koziatek C , Theobald J , Smith S , Iturrate E . Creation of a simple natural language processing tool to support an imaging utilization quality dashboard. Int J Med Inform. 2017;101:93-99. doi:10.1016/j.ijmedinf.2017.02.011 PubMed Google Scholar Crossref

Cui S , Chen S , Li X , Liu S , Wang F . Prevalence of venous thromboembolism in patients with severe novel coronavirus pneumonia. J Thromb Haemost. 2020;18(6):1421-1424. doi:10.1111/jth.14830 PubMed Google Scholar Crossref

Klok FA , Kruip MJHA , van der Meer NJM , et al. Incidence of thrombotic complications in critically ill ICU patients with COVID-19. Thromb Res. 2020;191:145-147. doi:10.1016/j.thromres.2020.04.013 PubMed Google Scholar Crossref

Grimnes G , Isaksen T , Tichelaar YIGV , Brækkan SK , Hansen JB . Acute infection as a trigger for incident venous thromboembolism: results from a population-based case-crossover study. Res Pract Thromb Haemost. 2017;2(1):85-92. doi:10.1002/rth2.12065 PubMed Google Scholar Crossref

Bunce PE , High SM , Nadjafi M , Stanley K , Liles WC , Christian MD . Pandemic H1N1 influenza infection and vascular thrombosis. Clin Infect Dis. 2011;52(2):e14-e17. doi:10.1093/cid/ciq125 PubMed Google Scholar Crossref

AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.