Journal article 105 views 41 downloads
Risks of major arterial and venous thrombotic diseases after hospitalisation for influenza, pneumonia, and COVID-19: A population-wide cohort in 2.6 million people in Wales
Spencer Keene,
Hoda Abbasizanjani 
,
Fatemeh Torabi ,
Rochelle Knight ,
Venexia Walker ,
Elena Raffetti ,
Genevieve Cezard ,
Samantha Ip ,
Alexia Sampri ,
Thomas Bolton,
Rachel Denholm ,
Kamlesh Khunti ,
Ashley Akbari ,
Jennifer Quint ,
Spiros Denaxas ,
Cathie Sudlow ,
Emanuele Di Angelantonio ,
Jonathan A.C. Sterne ,
Angela Wood ,
William N. Whiteley
,
Fatemeh Torabi ,
Rochelle Knight ,
Venexia Walker ,
Elena Raffetti ,
Genevieve Cezard ,
Samantha Ip ,
Alexia Sampri ,
Thomas Bolton,
Rachel Denholm ,
Kamlesh Khunti ,
Ashley Akbari ,
Jennifer Quint ,
Spiros Denaxas ,
Cathie Sudlow ,
Emanuele Di Angelantonio ,
Jonathan A.C. Sterne ,
Angela Wood ,
William N. Whiteley
Thrombosis Research, Volume: 245, Start page: 109213
Swansea University Authors:
Hoda Abbasizanjani , Fatemeh Torabi , Ashley Akbari
-
PDF | Version of Record
© 2024 The Authors. This is an open access article under the CC BY license.
Download (3.31MB)
DOI (Published version): 10.1016/j.thromres.2024.109213
Abstract
ObjectivePneumonia, influenza, COVID-19, and other common infections might increase the risk of thrombotic events acutely through an interaction between inflammation and the thrombotic system. The long-term risks of arterial and venous thrombotic events following hospitalisation for COVID-19 and hos...
| Published in: | Thrombosis Research |
|---|---|
| ISSN: | 0049-3848 |
| Published: |
Elsevier BV
2025
|
| Online Access: |
Check full text
|
| URI: | https://cronfa.swan.ac.uk/Record/cronfa68416 |
| first_indexed |
2025-01-30T16:02:05Z |
|---|---|
| last_indexed |
2025-02-04T14:29:27Z |
| id |
cronfa68416 |
| recordtype |
SURis |
| fullrecord |
<?xml version="1.0"?><rfc1807><datestamp>2025-02-04T11:28:02.8796359</datestamp><bib-version>v2</bib-version><id>68416</id><entry>2024-12-02</entry><title>Risks of major arterial and venous thrombotic diseases after hospitalisation for influenza, pneumonia, and COVID-19: A population-wide cohort in 2.6 million people in Wales</title><swanseaauthors><author><sid>93dd7e747f3118a99566c68592a3ddcc</sid><ORCID>0000-0002-9575-4758</ORCID><firstname>Hoda</firstname><surname>Abbasizanjani</surname><name>Hoda Abbasizanjani</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>f569591e1bfb0e405b8091f99fec45d3</sid><ORCID>0000-0002-5853-4625</ORCID><firstname>Fatemeh</firstname><surname>Torabi</surname><name>Fatemeh Torabi</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>aa1b025ec0243f708bb5eb0a93d6fb52</sid><ORCID>0000-0003-0814-0801</ORCID><firstname>Ashley</firstname><surname>Akbari</surname><name>Ashley Akbari</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2024-12-02</date><deptcode>MEDS</deptcode><abstract>ObjectivePneumonia, influenza, COVID-19, and other common infections might increase the risk of thrombotic events acutely through an interaction between inflammation and the thrombotic system. The long-term risks of arterial and venous thrombotic events following hospitalisation for COVID-19 and hospitalisation for pneumonia or influenza are unclear.Materials and methodsIn a population-wide cohort of linked Welsh health data of adults, we calculated the incidence of arterial and venous thrombosis after hospitalisation for COVID-19 (2020−2021). We then compared this post-hospitalisation incidence with the incidence prior to COVID-19 hospitalisation in the same individuals, and with the incidence in individuals who were never hospitalised for COVID-19. We then repeated this analysis for hospitalisation for pneumonia or influenza in a separate cohort (2016–2019). We estimated adjusted hazard ratios (aHRs) in separate time periods starting from the date of the first infection that resulted in hospitalisation (day 0, 1 to 7 days, 2 to 4 weeks, 5 to 16 weeks, and 17 to 75 weeks) using time-varying Cox regression. Confounders included age, sex, smoking status, obesity, deprivation (fifths of Welsh Index of Multiple Deprivation), rural or urban setting, care home attendance, Elixhauser comorbidity index, surgery in the last year, medications (e.g. lipid-lowering and antiplatelet/anticoagulant use), hypertension and/or hypertensive medication use, and past medical history of chronic kidney disease, diabetes, chronic obstructive pulmonary disease, dementia, cancer, or any CVD.ResultsFor the first arterial thrombosis, the aHRs were 3.80 (95 % CI: 2.50–5.77) between days 1–7, 5.24 (4.21–6.51) between weeks 2–4, 2.12 (1.72–2.60) between weeks 5–16, and 1.60 (1.38–1.86) between weeks 17–75 after hospitalisation for COVID-19. The corresponding aHRs after hospitalisation for pneumonia/influenza were: 5.42 (4.35–6.75), 3.87 (3.32–4.49), 1.96 (1.74–2.21), and 1.41 (1.30–1.53).For first venous thrombosis, aHRs were 7.47 (3.56–15.7) between days 1–7, 22.6 (17.5–29.1) between weeks 2–4, 6.58 (4.98–8.68) between weeks 5–16, and 2.25 (1.67–3.02) between weeks 17–75 after hospitalisation for COVID-19. The corresponding aHRs after hospitalisation for pneumonia/influenza were: 15.1 (10.3–22.0), 11.8 (9.23–15.1), 5.80 (4.75–7.08), and 1.89 (1.57–2.29).Excess risk was highest in individuals aged ≥60 years, in whom we estimated 2,700 and 2,320 additional arterial and 1,270 and 840 additional venous events after 100,000 hospitalisations for COVID-19 and pneumonia/influenza, respectively.ConclusionsBoth hospitalisation for COVID-19 and pneumonia/influenza increase the risk of arterial and venous thrombosis. Preventative healthcare policies are needed for cardiovascular risk factor management, vaccination, and anticoagulation in high-risk patients with hospitalised or severe infections.</abstract><type>Journal Article</type><journal>Thrombosis Research</journal><volume>245</volume><journalNumber/><paginationStart>109213</paginationStart><paginationEnd/><publisher>Elsevier BV</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>0049-3848</issnPrint><issnElectronic/><keywords>COVID-19* / epidemiology; Cohort studies; Hospitals; Influenza, human* / epidemiology; Influenza, human* / prevention &amp; control; SARS-CoV-2</keywords><publishedDay>1</publishedDay><publishedMonth>1</publishedMonth><publishedYear>2025</publishedYear><publishedDate>2025-01-01</publishedDate><doi>10.1016/j.thromres.2024.109213</doi><url/><notes/><college>COLLEGE NANME</college><department>Medical School</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>MEDS</DepartmentCode><institution>Swansea University</institution><apcterm>Another institution paid the OA fee</apcterm><funders>BHF, UK Stroke Association, HRDUK, Health and Care Research Wales.</funders><projectreference/><lastEdited>2025-02-04T11:28:02.8796359</lastEdited><Created>2024-12-02T18:50:53.5389250</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Health Data Science</level></path><authors><author><firstname>Spencer</firstname><surname>Keene</surname><order>1</order></author><author><firstname>Hoda</firstname><surname>Abbasizanjani</surname><orcid>0000-0002-9575-4758</orcid><order>2</order></author><author><firstname>Fatemeh</firstname><surname>Torabi</surname><orcid>0000-0002-5853-4625</orcid><order>3</order></author><author><firstname>Rochelle</firstname><surname>Knight</surname><orcid>0000-0002-4128-6821</orcid><order>4</order></author><author><firstname>Venexia</firstname><surname>Walker</surname><orcid>0000-0001-5064-446x</orcid><order>5</order></author><author><firstname>Elena</firstname><surname>Raffetti</surname><orcid>0000-0001-8742-3986</orcid><order>6</order></author><author><firstname>Genevieve</firstname><surname>Cezard</surname><orcid>0000-0002-3011-7416</orcid><order>7</order></author><author><firstname>Samantha</firstname><surname>Ip</surname><orcid>0000-0001-9162-6727</orcid><order>8</order></author><author><firstname>Alexia</firstname><surname>Sampri</surname><orcid>0000-0002-4889-7983</orcid><order>9</order></author><author><firstname>Thomas</firstname><surname>Bolton</surname><order>10</order></author><author><firstname>Rachel</firstname><surname>Denholm</surname><orcid>0000-0002-8067-5440</orcid><order>11</order></author><author><firstname>Kamlesh</firstname><surname>Khunti</surname><orcid>0000-0003-2343-7099</orcid><order>12</order></author><author><firstname>Ashley</firstname><surname>Akbari</surname><orcid>0000-0003-0814-0801</orcid><order>13</order></author><author><firstname>Jennifer</firstname><surname>Quint</surname><orcid>0000-0003-0149-4869</orcid><order>14</order></author><author><firstname>Spiros</firstname><surname>Denaxas</surname><orcid>0000-0001-9612-7791</orcid><order>15</order></author><author><firstname>Cathie</firstname><surname>Sudlow</surname><orcid>0000-0002-7725-7520</orcid><order>16</order></author><author><firstname>Emanuele Di</firstname><surname>Angelantonio</surname><orcid>0000-0001-8776-6719</orcid><order>17</order></author><author><firstname>Jonathan A.C.</firstname><surname>Sterne</surname><orcid>0000-0001-8496-6053</orcid><order>18</order></author><author><firstname>Angela</firstname><surname>Wood</surname><orcid>0000-0002-7937-304x</orcid><order>19</order></author><author><firstname>William N.</firstname><surname>Whiteley</surname><orcid>0000-0002-4816-8991</orcid><order>20</order></author></authors><documents><document><filename>68416__33487__cf76268ed8f44f21b2050a745a738fff.pdf</filename><originalFilename>68416.VoR.pdf</originalFilename><uploaded>2025-02-04T11:26:41.9575576</uploaded><type>Output</type><contentLength>3467312</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>© 2024 The Authors. This is an open access article under the CC BY license.</documentNotes><copyrightCorrect>true</copyrightCorrect><language>eng</language><licence>http://creativecommons.org/licenses/by/4.0/</licence></document></documents><OutputDurs/></rfc1807> |
| spelling |
2025-02-04T11:28:02.8796359 v2 68416 2024-12-02 Risks of major arterial and venous thrombotic diseases after hospitalisation for influenza, pneumonia, and COVID-19: A population-wide cohort in 2.6 million people in Wales 93dd7e747f3118a99566c68592a3ddcc 0000-0002-9575-4758 Hoda Abbasizanjani Hoda Abbasizanjani true false f569591e1bfb0e405b8091f99fec45d3 0000-0002-5853-4625 Fatemeh Torabi Fatemeh Torabi true false aa1b025ec0243f708bb5eb0a93d6fb52 0000-0003-0814-0801 Ashley Akbari Ashley Akbari true false 2024-12-02 MEDS ObjectivePneumonia, influenza, COVID-19, and other common infections might increase the risk of thrombotic events acutely through an interaction between inflammation and the thrombotic system. The long-term risks of arterial and venous thrombotic events following hospitalisation for COVID-19 and hospitalisation for pneumonia or influenza are unclear.Materials and methodsIn a population-wide cohort of linked Welsh health data of adults, we calculated the incidence of arterial and venous thrombosis after hospitalisation for COVID-19 (2020−2021). We then compared this post-hospitalisation incidence with the incidence prior to COVID-19 hospitalisation in the same individuals, and with the incidence in individuals who were never hospitalised for COVID-19. We then repeated this analysis for hospitalisation for pneumonia or influenza in a separate cohort (2016–2019). We estimated adjusted hazard ratios (aHRs) in separate time periods starting from the date of the first infection that resulted in hospitalisation (day 0, 1 to 7 days, 2 to 4 weeks, 5 to 16 weeks, and 17 to 75 weeks) using time-varying Cox regression. Confounders included age, sex, smoking status, obesity, deprivation (fifths of Welsh Index of Multiple Deprivation), rural or urban setting, care home attendance, Elixhauser comorbidity index, surgery in the last year, medications (e.g. lipid-lowering and antiplatelet/anticoagulant use), hypertension and/or hypertensive medication use, and past medical history of chronic kidney disease, diabetes, chronic obstructive pulmonary disease, dementia, cancer, or any CVD.ResultsFor the first arterial thrombosis, the aHRs were 3.80 (95 % CI: 2.50–5.77) between days 1–7, 5.24 (4.21–6.51) between weeks 2–4, 2.12 (1.72–2.60) between weeks 5–16, and 1.60 (1.38–1.86) between weeks 17–75 after hospitalisation for COVID-19. The corresponding aHRs after hospitalisation for pneumonia/influenza were: 5.42 (4.35–6.75), 3.87 (3.32–4.49), 1.96 (1.74–2.21), and 1.41 (1.30–1.53).For first venous thrombosis, aHRs were 7.47 (3.56–15.7) between days 1–7, 22.6 (17.5–29.1) between weeks 2–4, 6.58 (4.98–8.68) between weeks 5–16, and 2.25 (1.67–3.02) between weeks 17–75 after hospitalisation for COVID-19. The corresponding aHRs after hospitalisation for pneumonia/influenza were: 15.1 (10.3–22.0), 11.8 (9.23–15.1), 5.80 (4.75–7.08), and 1.89 (1.57–2.29).Excess risk was highest in individuals aged ≥60 years, in whom we estimated 2,700 and 2,320 additional arterial and 1,270 and 840 additional venous events after 100,000 hospitalisations for COVID-19 and pneumonia/influenza, respectively.ConclusionsBoth hospitalisation for COVID-19 and pneumonia/influenza increase the risk of arterial and venous thrombosis. Preventative healthcare policies are needed for cardiovascular risk factor management, vaccination, and anticoagulation in high-risk patients with hospitalised or severe infections. Journal Article Thrombosis Research 245 109213 Elsevier BV 0049-3848 COVID-19* / epidemiology; Cohort studies; Hospitals; Influenza, human* / epidemiology; Influenza, human* / prevention & control; SARS-CoV-2 1 1 2025 2025-01-01 10.1016/j.thromres.2024.109213 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University Another institution paid the OA fee BHF, UK Stroke Association, HRDUK, Health and Care Research Wales. 2025-02-04T11:28:02.8796359 2024-12-02T18:50:53.5389250 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science Spencer Keene 1 Hoda Abbasizanjani 0000-0002-9575-4758 2 Fatemeh Torabi 0000-0002-5853-4625 3 Rochelle Knight 0000-0002-4128-6821 4 Venexia Walker 0000-0001-5064-446x 5 Elena Raffetti 0000-0001-8742-3986 6 Genevieve Cezard 0000-0002-3011-7416 7 Samantha Ip 0000-0001-9162-6727 8 Alexia Sampri 0000-0002-4889-7983 9 Thomas Bolton 10 Rachel Denholm 0000-0002-8067-5440 11 Kamlesh Khunti 0000-0003-2343-7099 12 Ashley Akbari 0000-0003-0814-0801 13 Jennifer Quint 0000-0003-0149-4869 14 Spiros Denaxas 0000-0001-9612-7791 15 Cathie Sudlow 0000-0002-7725-7520 16 Emanuele Di Angelantonio 0000-0001-8776-6719 17 Jonathan A.C. Sterne 0000-0001-8496-6053 18 Angela Wood 0000-0002-7937-304x 19 William N. Whiteley 0000-0002-4816-8991 20 68416__33487__cf76268ed8f44f21b2050a745a738fff.pdf 68416.VoR.pdf 2025-02-04T11:26:41.9575576 Output 3467312 application/pdf Version of Record true © 2024 The Authors. This is an open access article under the CC BY license. true eng http://creativecommons.org/licenses/by/4.0/ |
| title |
Risks of major arterial and venous thrombotic diseases after hospitalisation for influenza, pneumonia, and COVID-19: A population-wide cohort in 2.6 million people in Wales |
| spellingShingle |
Risks of major arterial and venous thrombotic diseases after hospitalisation for influenza, pneumonia, and COVID-19: A population-wide cohort in 2.6 million people in Wales Hoda Abbasizanjani Fatemeh Torabi Ashley Akbari |
| title_short |
Risks of major arterial and venous thrombotic diseases after hospitalisation for influenza, pneumonia, and COVID-19: A population-wide cohort in 2.6 million people in Wales |
| title_full |
Risks of major arterial and venous thrombotic diseases after hospitalisation for influenza, pneumonia, and COVID-19: A population-wide cohort in 2.6 million people in Wales |
| title_fullStr |
Risks of major arterial and venous thrombotic diseases after hospitalisation for influenza, pneumonia, and COVID-19: A population-wide cohort in 2.6 million people in Wales |
| title_full_unstemmed |
Risks of major arterial and venous thrombotic diseases after hospitalisation for influenza, pneumonia, and COVID-19: A population-wide cohort in 2.6 million people in Wales |
| title_sort |
Risks of major arterial and venous thrombotic diseases after hospitalisation for influenza, pneumonia, and COVID-19: A population-wide cohort in 2.6 million people in Wales |
| author_id_str_mv |
93dd7e747f3118a99566c68592a3ddcc f569591e1bfb0e405b8091f99fec45d3 aa1b025ec0243f708bb5eb0a93d6fb52 |
| author_id_fullname_str_mv |
93dd7e747f3118a99566c68592a3ddcc_***_Hoda Abbasizanjani f569591e1bfb0e405b8091f99fec45d3_***_Fatemeh Torabi aa1b025ec0243f708bb5eb0a93d6fb52_***_Ashley Akbari |
| author |
Hoda Abbasizanjani Fatemeh Torabi Ashley Akbari |
| author2 |
Spencer Keene Hoda Abbasizanjani Fatemeh Torabi Rochelle Knight Venexia Walker Elena Raffetti Genevieve Cezard Samantha Ip Alexia Sampri Thomas Bolton Rachel Denholm Kamlesh Khunti Ashley Akbari Jennifer Quint Spiros Denaxas Cathie Sudlow Emanuele Di Angelantonio Jonathan A.C. Sterne Angela Wood William N. Whiteley |
| format |
Journal article |
| container_title |
Thrombosis Research |
| container_volume |
245 |
| container_start_page |
109213 |
| publishDate |
2025 |
| institution |
Swansea University |
| issn |
0049-3848 |
| doi_str_mv |
10.1016/j.thromres.2024.109213 |
| publisher |
Elsevier BV |
| college_str |
Faculty of Medicine, Health and Life Sciences |
| hierarchytype |
|
| hierarchy_top_id |
facultyofmedicinehealthandlifesciences |
| hierarchy_top_title |
Faculty of Medicine, Health and Life Sciences |
| hierarchy_parent_id |
facultyofmedicinehealthandlifesciences |
| hierarchy_parent_title |
Faculty of Medicine, Health and Life Sciences |
| department_str |
Swansea University Medical School - Health Data Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Health Data Science |
| document_store_str |
1 |
| active_str |
0 |
| description |
ObjectivePneumonia, influenza, COVID-19, and other common infections might increase the risk of thrombotic events acutely through an interaction between inflammation and the thrombotic system. The long-term risks of arterial and venous thrombotic events following hospitalisation for COVID-19 and hospitalisation for pneumonia or influenza are unclear.Materials and methodsIn a population-wide cohort of linked Welsh health data of adults, we calculated the incidence of arterial and venous thrombosis after hospitalisation for COVID-19 (2020−2021). We then compared this post-hospitalisation incidence with the incidence prior to COVID-19 hospitalisation in the same individuals, and with the incidence in individuals who were never hospitalised for COVID-19. We then repeated this analysis for hospitalisation for pneumonia or influenza in a separate cohort (2016–2019). We estimated adjusted hazard ratios (aHRs) in separate time periods starting from the date of the first infection that resulted in hospitalisation (day 0, 1 to 7 days, 2 to 4 weeks, 5 to 16 weeks, and 17 to 75 weeks) using time-varying Cox regression. Confounders included age, sex, smoking status, obesity, deprivation (fifths of Welsh Index of Multiple Deprivation), rural or urban setting, care home attendance, Elixhauser comorbidity index, surgery in the last year, medications (e.g. lipid-lowering and antiplatelet/anticoagulant use), hypertension and/or hypertensive medication use, and past medical history of chronic kidney disease, diabetes, chronic obstructive pulmonary disease, dementia, cancer, or any CVD.ResultsFor the first arterial thrombosis, the aHRs were 3.80 (95 % CI: 2.50–5.77) between days 1–7, 5.24 (4.21–6.51) between weeks 2–4, 2.12 (1.72–2.60) between weeks 5–16, and 1.60 (1.38–1.86) between weeks 17–75 after hospitalisation for COVID-19. The corresponding aHRs after hospitalisation for pneumonia/influenza were: 5.42 (4.35–6.75), 3.87 (3.32–4.49), 1.96 (1.74–2.21), and 1.41 (1.30–1.53).For first venous thrombosis, aHRs were 7.47 (3.56–15.7) between days 1–7, 22.6 (17.5–29.1) between weeks 2–4, 6.58 (4.98–8.68) between weeks 5–16, and 2.25 (1.67–3.02) between weeks 17–75 after hospitalisation for COVID-19. The corresponding aHRs after hospitalisation for pneumonia/influenza were: 15.1 (10.3–22.0), 11.8 (9.23–15.1), 5.80 (4.75–7.08), and 1.89 (1.57–2.29).Excess risk was highest in individuals aged ≥60 years, in whom we estimated 2,700 and 2,320 additional arterial and 1,270 and 840 additional venous events after 100,000 hospitalisations for COVID-19 and pneumonia/influenza, respectively.ConclusionsBoth hospitalisation for COVID-19 and pneumonia/influenza increase the risk of arterial and venous thrombosis. Preventative healthcare policies are needed for cardiovascular risk factor management, vaccination, and anticoagulation in high-risk patients with hospitalised or severe infections. |
| published_date |
2025-01-01T09:38:39Z |
| _version_ |
1830272546062204928 |
| score |
11.05955 |