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Mortality of COVID-19 patients with vascular thrombotic complications

José A Gonzalez-Fajardo1, Marina Ansuategui1, Carmen Romero2

  • 1Servicio de Medicina Preventiva, Hospital Universitario 12 de Octubre, Madrid, Spain.

Medicina Clinica (English Ed.)
|February 1, 2021
PubMed

Insights

COVID-19 patients with vascular thrombosis face high mortality, especially with arterial events like peripheral arterial thrombosis (PAT) and ischemic stroke. Venous thromboembolism (VTE) is more common, but survival is better for deep vein thrombosis (DVT) and pulmonary embolism (PE).

Area of Science:

  • Internal Medicine
  • Cardiology
  • Infectious Diseases

Background:

  • COVID-19 is associated with an increased risk of vascular thrombotic complications.
  • Understanding the specific risks and outcomes of different thrombotic events in COVID-19 patients is crucial for clinical management.

Purpose of the Study:

  • To analyze the survival rates of hospitalized COVID-19 patients who experienced vascular thrombotic complications.
  • To compare the mortality associated with different types of thrombosis, including deep vein thrombosis (DVT), pulmonary embolism (PE), ischemic stroke, and peripheral arterial thrombosis (PAT).

Main Methods:

  • A cohort of 2943 COVID-19 patients admitted between March and April 2020 was analyzed.
  • 106 patients with objectively confirmed symptomatic vascular thrombosis (DVT, PE, ischemic stroke, PAT) were identified.
  • Survival analysis was performed using Kaplan-Meier curves, Log Rank test, and Cox regression.

Main Results:

  • Vascular thrombosis occurred in 106 (3.6%) of COVID-19 patients, with PE being the most frequent (58 cases).
  • Mortality was significantly higher in patients with arterial thrombosis (PAT: 69.2%, ischemic stroke: 53.3%) compared to venous thrombosis (DVT: 5%, PE: 12.1%).
  • Overall hospital mortality for patients with vascular thrombosis was 23.58% (25 deaths).

Conclusions:

  • While venous thromboembolism (VTE) is more common in COVID-19, arterial thrombosis (AT) carries a substantially higher mortality risk.
  • Survival outcomes were poorer for patients with ischemic stroke and PAT compared to those with DVT and PE.
  • These findings highlight the critical need for vigilant monitoring and management of thrombotic complications in COVID-19 patients.
Abstract

Keywords:
COVID-19MortalityThrombosis

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