Blood clot risk remains elevated nearly a year after COVID-19

感染COVID-19的人在近一年后出现危险血栓的风险更高, 根据一项关于疫苗问世前SARS-CoV-2感染后遗症的大型新研究.

正如之前的研究所见, 与从未感染过COVID-19的人相比，COVID-19与诊断后立即发生血块相关问题(包括心脏病发作和中风)的风险急剧增加有关. 但这项新研究发现，49周后出现某些问题的风险仍然较高.

在这一点上, 与没有感染COVID-19的人相比，感染COVID-19的人患深静脉血栓(在大静脉中形成的血栓)的风险几乎是两倍, according to the study published Monday in the 美国心脏协会 journal 循环.

该研究使用了从英国国家卫生系统从2020年1月到12月COVID-19疫苗提供前一天匿名收集的4800万人(几乎是英格兰和威尔士的每个成年人)的数据.

研究结果强化了这样一个信息:对于有心血管疾病的人来说, “服用现有的预防性药物和管理风险因素现在比大流行之前更加重要,乔纳森·斯特恩说, 该研究的资深作者，英国布里斯托尔大学医学统计和流行病学教授.

The study looked at results from 1.4 million diagnoses of COVID-19, which researchers said led to an estimated 10,500 additional cases of clot-related problems.

英国各地广泛的数据收集和联系使研究人员能够处理这些数字, 斯特恩说.

Researchers found that the first week after a COVID-19 diagnosis, 动脉血栓的风险——即通过阻止血液流向心脏或大脑而可能导致心脏病发作或缺血性中风的那种——比没有COVID-19的人高出近22倍. That risk dropped sharply, to less than four times higher, in the second week.

“在27到49周之间, there is an approximately 30% increased risk for arterial clots, 斯特恩说. "But the elevation is greater for longer" for clots in veins, which include deep vein thrombosis and pulmonary embolism, when a clot travels to the lungs.

在诊断出COVID-19后的第一周，此类静脉问题的风险高出33倍. 在确诊后的第三周和第四周，患病风险仍高出约8倍. And between 27 and 49 weeks later, the risk was still 1.8 times higher than in somebody who had never had COVID-19.

“我确实认为这是一个新的因素——风险不仅仅是在急性COVID感染的时候,”医生说。. 凯伦·富里, 罗得岛医院神经内科主任，普罗维登斯布朗大学沃伦·阿尔珀特医学院神经内科主任. The higher risk of clots in veins than in arteries also got her attention. Furie was not involved in the study.

Elevated risks persisted no matter whether someone was hospitalized for COVID-19, although risks were greater in people who were hospitalized. The study also showed that clot risks were higher in Black and Asian people.

Overall, however, clots were rare. 在COVID-19诊断后的49周内，发生动脉血栓的风险总体增加为0.5%. For a venous clot, the risk was 0.25%. 后1.4 million COVID-19 diagnoses, 这相当于7,200 additional heart attacks or strokes, 和3,500 additional cases of pulmonary embolism, deep vein thrombosis or other venous problems.

Furie said the size of the study made it "extremely powerful.但作者承认，在检测广泛普及之前，他们可能错过了一些COVID-19病例, or vascular events if people avoided hospitals early in the pandemic.

尽管自研究开始以来，已经出现了导致COVID-19的冠状病毒的几种变体, Furie said the information remains relevant. The study confirms "that infection with COVID, and other viruses for that matter, do have an inflammatory effect that can stimulate thrombotic events,她说.

Given that risks can be elevated for close to a year, Furie说，应该对人们进行筛查和监测，以发现任何可以通过预防性治疗减轻的风险因素的证据, such as blood-thinning medications.

研究期间出现的治疗方案已经朝着这个方向发展, 她说, but the new findings suggest problems might need to be managed more aggressively. "I think that this puts a new perspective on that period of subsequent risk."

斯特恩说 the findings are likely to apply broadly outside England and Wales. A follow-up study is looking at the period from June 2021 onward, 当冠状病毒的丁型和组粒变体占主导地位时，当许多人接种了疫苗时. The Centers for Disease Control and Prevention 建议 人们及时了解其年龄组的COVID-19疫苗接种情况，以预防严重疾病, 住院和死亡.

现在, 斯特恩说, the study shows that if someone had COVID-19, “那么他们应该和医生讨论如何控制心血管风险, which is likely to be increased for some level of time."

编者注:由于围绕冠状病毒的线上娱乐电子游戏网站迅速演变, the facts and advice presented in this story may have changed since publication. 访问的心.Org获取最新报道, 并向疾病控制和预防中心以及当地卫生官员咨询最新的指导意见.

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