COVID-19 and Recurrent Venous Thromboembolism (CORE-VTE).
Bibliographic record
Abstract
Background: Venous thromboembolism (VTE) events occur in association with COVID-19, and the optimal duration of anticoagulant treatment is uncertain. Objectives: The primary objectives were to determine the duration of anticoagulant prescriptions filled after COVID-19–associated VTE and the proportion of patients experiencing VTE recurrence. The secondary objective was to determine the proportion of patients who experienced bleeding events. Methods: This retrospective cohort study analyzed data for cases of COVID-19–associated VTE across Alberta, Canada, confirmed between February 23, 2020, and June 30, 2022. Outpatient cases of VTE were identified using codes from the International Classification of Diseases, Ninth Revision plus Alberta Health Service procedure codes. Inpatient cases of VTE and bleeding events were identified using codes from the International Classification of Diseases and Related Health Problems, 10th Revision. Results: Among the 822 patients included in the analysis, median follow-up was 359.0 days, with the majority of follow-up occurring while patients were off treatment (median 273.0 days). The median age was 59 years, 61.9% of the patients were male, 82.1% had a pulmonary embolism, 71.9% had not received COVID-19 vaccinations, and the median Charlson comorbidity index score was 1. The median duration of treatment was 100.0 (interquartile range 71.0–190.0) days, with 360 patients (43.8%) filling their prescriptions for 0–3 months, 234 (28.5%) for 4–6 months, 181 (22.0%) for 7–12 months, and 47 (5.7%) for more than 12 months. Overall, recurrent VTE occurred in 49 patients (6.0%), 24 of whom had continuously filled their anticoagulant prescriptions up to the time of the event. Bleeding occurred in 72 patients (8.8%). Conclusions: Given the prolonged follow-up period off anticoagulant treatment for most patients, it is reasonable to consider 3–6 months of therapy for COVID-19–associated VTE. Keywords: anticoagulants, COVID-19, venous thromboembolism, deep vein thrombosis, pulmonary embolism RÉSUMÉ Contexte : Les événements de thromboembolie veineuse (TEV) surviennent en association avec la COVID-19, et la durée optimale du traitement anticoagulant est incertaine. Objectifs : L’objectif principal consistait à déterminer la durée des ordonnances d’anticoagulants exécutées après une TEV associée à la COVID-19 et la part des patients chez qui la TEV avait récidivé. L’objectif secondaire consistait à déterminer la part des patients vivant des événements hémorragiques. Méthodologie : Cette étude de cohorte rétrospective a analysé les données des cas de TEV associés à la COVID-19 en Alberta, au Canada, confirmés entre le 23 février 2020 et le 30 juin 2022. Les cas ambulatoires de TEV ont été identifiés à l’aide des codes de la Classification internationale des maladies, neuvième révision, ainsi que des Codes de procédure des Services de santé de l’Alberta. Les hospitalisations pour TEV et les événements hémorragiques ont été identifiés à l’aide des codes de la Classification internationale des maladies et des problèmes de santé connexes, dixième révision. Résultats : Parmi les 822 patients inclus dans l’analyse, le suivi médian était de 359,0 jours, la majorité du suivi ayant eu lieu lorsque les patients n’étaient plus sous traitement (médian 273,0 jours). L’âge médian était de 59 ans; 61,9 % des patients étaient des hommes; 82,1 % avaient une embolie pulmonaire; 71,9 % n’avaient pas reçu de vaccination contre la COVID-19; et le score médian de l’indice de comorbidité de Charlson était de 1. La durée médiane du traitement était de 100 jours (écart interquartile 71–190 jours), avec 360 patients (43,8 %) ayant exécuté leur prescription pendant 0 à 3 mois, 234 (28,5 %) pendant 4 à 6 mois, 181 (22,0 %) pendant 7 à 12 mois, et 47 (5,7 %) pendant plus de 12 mois. Globalement, une récidive de la TEV est survenue chez 49 patients (6,0 %), dont 24 avaient continuellement exécuté leur ordonnance d’anticoagulants jusqu’à l’événement. Des saignements sont survenus chez 72 patients (8,8 %). Conclusions : Étant donné la durée prolongée du suivi sans traitement anticoagulant pour la plupart des patients, il est raisonnable de considérer 3 à 6 mois de traitement pour la TEV associée à la COVID-19. Mots-clés : anticoagulants, COVID-19, thromboembolie veineuse, thrombose veineuse profonde, embolie pulmonaire
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".