• Andrea Poloni, Giacomo Casalini, Giacomo Pozza, Andrea Giacomelli, Marta Colaneri, Giorgia Carrozzo, Beatrice Caloni, Cosmin Lucian Ciubotariu, Martina Zacheo, Andrea Rabbione, Margherita Pieruzzi, Federico Barone, Matteo Passerini, Anna Lisa Ridolfo, Giuliano Rizzardini, Andrea Gori, and Spinello Antinori.
• Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, 20122 Milan, Italy.
• Medicina (Kaunas). 2024 May 15; 60 (5).

AbstractThromboprophylaxis/anticoagulation treatment is often required in hospitalized COVID-19 patients. We aimed to estimate the prevalence of major bleeding events in hospitalized COVID-19 patients. This was a retrospective observational study including all COVID-19 hospitalized patients ≥18 years of age at one reference center in northern Italy. The crude prevalence (between February 2020-2022) of major bleeding events was estimated as the number of major bleeding episodes divided by patients at risk. Uni- and multivariable Cox models were built to assess factors potentially associated with major bleeding events. Twenty-nine (0.98%) out of 2,945 COVID-19 patients experienced a major bleeding event [prevalence of 0.55% (95%CI 0.37-0.79)], of which five were fatal. Patients who experienced a major bleeding event were older [78 years (72-84 IQR) vs. 67 years (55-78 IQR), p-value < 0.001] and more frequently exposed to anti-aggregating therapy (44.8% vs. 20.0%, p-value 0.002) when compared to those who did not. In the multivariable Cox model, age [per 1 year more AHR 1.05 (CI95% 1.02-1.09)] was independently associated with an increased risk of major bleeding events. A strict monitoring of older hospitalized COVID-19 patients is warranted due to the risk of major bleeding events.

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