Hemorrhage, Disseminated Intravascular Coagulopathy, and Thrombosis Complications Among Critically Ill Patients with COVID-19: An International COVID-19 Critical Care Consortium Study*
An erratum to this article was published (Crit Care Med, 1 Aug 2023 ↗)
Authors' conclusion
HECTOR events are frequent complications of severe COVID-19 in ICU patients. Patients receiving ECMO are at particular risk of hemorrhagic complications. Hemorrhagic, but not thrombotic complications, are associated with increased ICU mortality.
Study context
- Population
- Adults (≥ 16 yr) admitted to 229 ICUs in 32 countries for severe COVID-19, January 1, 2020, to December 31, 2021study eligible
- Participants
- 11,969 adults
- Exposure
- Patients with vs without HECTOR complications
- HECTORn = 1,732
- Outcome
- Prevalence of HECTOR complications
Methodological detailsmulticentre, international
- Multicentre
- International
Main finding
As reported in the abstract
- Any HECTOR complication (1,732/11,969)
- 14%
- Acute thrombosis (1,249 patients)
- 10%
- Pulmonary embolism among thrombosis (712)
- 57%
- Myocardial ischemia among thrombosis (413)
- 33%
- DVT among thrombosis (93)
- 7.4%
- Ischemic stroke among thrombosis (49)
- 3.9%
- Hemorrhagic complications (579 patients)
- 4.8%
- Gastrointestinal hemorrhage among hemorrhage (276)
- 48%
- Hemorrhagic stroke among hemorrhage (83)
- 14%
- Pulmonary hemorrhage among hemorrhage (77)
- 13%
- Extracorporeal membrane oxygenation (ECMO) cannula-site hemorrhage among hemorrhage (68)
- 12%
- Disseminated intravascular coagulation (11 patients)
- 0.09%
Observational data: associations, not effects.
Further findings
ICU LOS among survivors
P < 0.001
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| ICU mortalityOverall | 1.01 (0.92–1.12) | P = 0.784 | |
| ICU mortalitynon-ECMO patients | 1.13 (1.02–1.25) | P = 0.015 | |
| ICU mortality by complication typeHemorrhagic complications vs No HECTOR | 1.26 (1.09–1.45) | P = 0.002 | |
| ICU mortality by complication typeThrombosis complications vs No HECTOR | 0.88 (0.79–0.99) | P = 0.03 | |
| 0.512Hazard ratio (log scale) |
Risk factors for HECTOR (univariate analysis)
- Diabetes, cardiac and kidney diseases, and ECMO use were risk factors
- Univariate analysis
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Hemorrhage, Disseminated Intravascular Coagulopathy, and Thrombosis Complications Among Critically Ill Patients with COVID-19: An International COVID-19 Critical Care Consortium Study*. Crit Care Med. Published 28 February 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →