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Mortality and bleeding complications of COVID-19 critically ill patients with venous thromboembolism

Daniel Gil-Sala1,2, Claudia Riera3, Marvin García-Reyes4,2

  • 1Department of Angiology and Vascular Surgery, Hospital Universitari Vall d'Hebron - HUVH, Barcelona, Spain.

International Angiology : a Journal of the International Union of Angiology
|November 9, 2021
PubMed

Insights

Critically ill COVID-19 patients in the ICU experience high rates of venous thromboembolism (VTE) but low bleeding risk. Admission D-dimer levels and other factors can predict mortality in these patients.

Area of Science:

  • Critical care medicine
  • Infectious diseases
  • Hematology

Background:

  • Venous thromboembolism (VTE) is a significant concern in COVID-19 patients, particularly regarding its association with bleeding and mortality.
  • Understanding VTE outcomes in critically ill COVID-19 patients admitted to the Intensive Care Unit (ICU) is crucial.

Purpose of the Study:

  • To describe the outcomes of critically ill COVID-19 patients in the ICU concerning VTE during their hospitalization.
  • To identify predictors of VTE, bleeding events, and mortality in this patient population.

Main Methods:

  • A prospective cohort study involving 230 critically ill COVID-19 patients across two hospitals.
  • Venous ultrasound of both lower limbs was performed at baseline, with additional imaging for suspected new VTE during 30-day follow-up.
  • Data collected included VTE frequency, major bleeding events, survival, and their associated predictors.

Main Results:

  • A high frequency of VTE events (37.4%) was observed within 30 days.
  • Major bleeding complications occurred in 5.7% of patients, and mortality was 18.3%.
  • Admission D-dimer levels significantly correlated with VTE development and mortality. Independent predictors of mortality included older age, elevated D-dimer, and low lymphocyte count, achieving an AUC of 0.81.

Conclusions:

  • Critically ill COVID-19 patients in the ICU exhibit a high incidence of VTE with a low risk of major bleeding.
  • Admission laboratory parameters, such as D-dimer and lymphocyte count, alongside age, are valuable for predicting mortality in these patients.
Abstract

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