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Arterial Thrombotic Events in Adult Inpatients With COVID-19

Morgane Fournier1, Dorothée Faille2, Antoine Dossier1

  • 1Département de Médecine Interne, Hôpital Bichat, Assistance Publique Hôpitaux de Paris, Université de Paris, France.

Mayo Clinic Proceedings
|February 7, 2021
PubMed

Insights

Arterial thrombotic events occurred in 5.6% of hospitalized COVID-19 patients, increasing mortality risk. Elevated D-dimer levels over 1250 ng/mL identified high-risk individuals for these dangerous events.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Vascular Medicine

Background:

  • Coronavirus disease 2019 (COVID-19) is associated with a hypercoagulable state.
  • Arterial thrombotic events (ATEs) are a serious complication of COVID-19 infection.
  • Understanding risk factors for ATEs in COVID-19 patients is crucial for clinical management.

Purpose of the Study:

  • To evaluate the clinical course of arterial thrombotic events in adult inpatients with COVID-19.
  • To identify risk factors associated with the occurrence of ATEs in COVID-19 patients.
  • To assess the impact of ATEs on mortality in hospitalized COVID-19 patients.

Main Methods:

  • Retrospective analysis of consecutive adult COVID-19 patients admitted to a French referral center.
  • Data collection on demographic, clinical, laboratory, and treatment variables.
  • Analysis of arterial thrombotic events occurring from admission through discharge.

Main Results:

  • Among 531 COVID-19 patients, 5.6% experienced ATEs.
  • ATEs occurred at a median of 11 days post-symptom onset and were associated with traditional cardiovascular risk factors.
  • Patients with ATEs had a 3-fold increased risk of in-hospital death (HR 2.96).
  • D-dimer levels >1250 ng/mL significantly increased the risk of ATEs (SHR 7.68).

Conclusions:

  • Hospitalized COVID-19 patients experiencing ATEs have a dramatically high in-hospital mortality rate.
  • Elevated D-dimer levels (>1250 ng/mL) at admission may identify COVID-19 patients at increased risk for ATEs.
  • Early identification and management of ATE risk factors are essential in COVID-19 care.
Abstract

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