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COVID-19 Infection in Critically Ill Patients Carries a High Risk of Venous Thrombo-embolism

Sergi Bellmunt-Montoya1, Claudia Riera2, Daniel Gil1

  • 1Angiology and Vascular Surgery Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona (UAB), Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.

European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery
|February 15, 2021
PubMed

Insights

Critically ill COVID-19 patients have a high risk of venous thrombo-embolism (VTE), with over 26% experiencing VTE. D-dimer levels above 1500 ng/mL indicate VTE, and increased prophylaxis may be needed.

Area of Science:

  • Critical Care Medicine
  • Infectious Diseases
  • Hematology

Background:

  • COVID-19 infection is associated with an elevated risk of venous thrombo-embolism (VTE).
  • Understanding the frequency and risk factors for VTE in critically ill COVID-19 patients is crucial for effective management.

Purpose of the Study:

  • To determine the incidence of VTE in critically ill COVID-19 patients.
  • To investigate the correlation between VTE and D-dimer levels.
  • To assess the effectiveness of pharmacological prophylaxis in preventing VTE.

Main Methods:

  • A cohort study involving critically ill COVID-19 patients admitted to the ICU.
  • Venous duplex ultrasound and computed tomography angiography were used to diagnose VTE.
  • Data collected included patient characteristics, blood test results, thromboprophylaxis, VTE events, and mortality.

Main Results:

  • VTE occurred in 26.5% of critically ill COVID-19 patients (45 DVT, 16 PE).
  • D-dimer levels ≥ 1500 ng/mL were diagnostic of VTE with 80% sensitivity.
  • New VTE events and recurrences were observed despite therapeutic anticoagulation.

Conclusions:

  • Critically ill COVID-19 patients face a significant risk of VTE.
  • Anticoagulant prophylaxis may require dose adjustments in certain patients to mitigate bleeding risk.
  • Further research into optimal VTE prevention strategies for this population is warranted.
Abstract

Keywords:
COVID-19Deep vein thrombosisPulmonary embolismSARS-CoV-2 infectionVenous thromboembolism

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