ArticleJournal of thrombosis and haemostasis : JTH2021
Bleeding risk in hospitalized patients with COVID-19 receiving intermediate- or therapeutic doses of thromboprophylaxis.
Article in Journal of thrombosis and haemostasis : JTH, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 1 of them a synthesis that pooled it.
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Who cites it
33 citing papers in PubMed, 1 synthesis or guideline pooled it, 53 citations in OpenAlex.
- Efficacy of different anticoagulant doses for patients with COVID-19: a systematic review and network meta-analysis.Infection · 2022Pooled it
- Trends in Comorbidity for Patients with Venous Thromboembolism in a General Hospital: 2018 to 2022.Clinics and practice · 2026Article
- Adjudicated Cardiovascular Events in Patients With COVID-19: Association With Vaccination Status and Changes over Time.Journal of the American Heart Association · 2025Article
- Short and long-term outcomes of COVID-19-associated venous thromboembolism: a propensity score-matched cohort study.Internal and emergency medicine · 2025Article
- External Validation of the IMPROVE Risk Score for Predicting Bleeding in Hospitalized COVID-19 Patients.Journal of general internal medicine · 2025Article
- Thrombosis and Bleeding Risk Scores Are Strongly Associated with Mortality in Hospitalized Patients with COVID-19: A Multicenter Cohort Study.Journal of clinical medicine · 2024Article
- Death and Venous Thromboembolism Analyses among Hospitalized COVID-19-Positive Patients: A Multicenter Study.Journal of clinical medicine · 2023Article
- A retrospective multicenter cohort study of the association between anti-Factor Xa values and death, thromboembolism, and bleeding in patients with critical COVID-19.Thrombosis journal · 2023Article
- COVID-19-associated venous thromboembolism: risk of recurrence and major bleeding.Research and practice in thrombosis and haemostasis · 2023Article
- Outcomes of viral myocarditis in patients with and without COVID-19: a nationwide analysis from the United States.Annals of medicine and surgery (2012) · 2023Article
- Risk of thrombosis recurrence among patients with COVID-19 and surgery-associated venous thromboembolism.Revista clinica espanola · 2023Observational
- [Risk of thrombosis recurrence among patients with COVID-19- and surgery-associated venous thromboembolism].Revista clinica espanola · 2023Article
- Reply to Bareille et al. Are Viscoelastometric Assays of Old Generation Ready for Disposal? Comment on "Volod et al. Viscoelastic Hemostatic Assays: A Primer on Legacy and New Generation Devices.Journal of clinical medicine · 2023Article
- Thromboembolic and bleeding events in ICU patients with COVID-19: A nationwide, observational study.Acta anaesthesiologica Scandinavica · 2023Observational
- Incidence, risk factors, and clinical impact of major bleeding in hospitalized patients with COVID-19: a sub-analysis of the CLOT-COVID Study.Thrombosis journal · 2022Article
- Fixed-Dose Ultrasound-Assisted Catheter-Directed Thrombolysis for Acute Pulmonary Embolism Associated with COVID-19.Viruses · 2022Article
- Article
- Biomarker derived risk scores predict venous thromboembolism and major bleeding among patients with COVID-19.Research and practice in thrombosis and haemostasis · 2022Article
- Response.Chest · 2022Article
- Retroperitoneal Hemorrhage in Patients with COVID-19 Undergoing Hemodialysis: Three Case Reports.Internal medicine (Tokyo, Japan) · 2022Article
Corrections and comments
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Authors and funding
12 authors at 9 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionSome local protocols suggest using intermediate or therapeutic doses of anticoagulants for thromboprophylaxis in hospitalized patients with coronavirus disease 2019 (COVID-19). However, the incidence of bleeding, predictors of major bleeding, or the association between bleeding and mortality remain largely unknown.
methodsWe performed a cohort study of patients hospitalized for COVID-19 that received intermediate or therapeutic doses of anticoagulants from March 25 to July 22, 2020, to identify those at increased risk for major bleeding. We used bivariate and multivariable logistic regression to explore the risk factors associated with major bleeding.
resultsDuring the study period, 1965 patients were enrolled. Of them, 1347 (69%) received intermediate- and 618 (31%) therapeutic-dose anticoagulation, with a median duration of 12 days in both groups. During the hospital stay, 112 patients (5.7%) developed major bleeding and 132 (6.7%) had non-major bleeding. The 30-day all-cause mortality rate for major bleeding was 45% (95% confidence interval [CI]: 36%-54%) and for non-major bleeding 32% (95% CI: 24%-40%). Multivariable analysis showed increased risk for in-hospital major bleeding associated with D-dimer levels >10 times the upper normal range (hazard ratio [HR], 2.23; 95% CI, 1.38-3.59), ferritin levels >500 ng/ml (HR, 2.01; 95% CI, 1.02-3.95), critical illness (HR, 1.91; 95% CI, 1.14-3.18), and therapeutic-intensity anticoagulation (HR, 1.43; 95% CI, 1.01-1.97).
conclusionsAmong patients hospitalized with COVID-19 receiving intermediate- or therapeutic-intensity anticoagulation, a major bleeding event occurred in 5.7%. Use of therapeutic-intensity anticoagulation, critical illness, and elevated D-dimer or ferritin levels at admission were associated with increased risk for major bleeding.
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