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Published on: May 24, 2020
[Thromboembolic complications in patients with COVID-19]
Nicolás Lalor1, Alesis Raffaeli1, Natalia Torres2
1Servicio Cardiología, Sanatorio Anchorena, Buenos Aires, Argentina.
Insights
Patients hospitalized with Coronavirus disease 2019 (COVID-19) face a high risk of thromboembolic events, particularly in intensive care. These events negatively impact survival despite prophylactic heparin use.
Area of Science:
- Medical research
- Infectious diseases
- Cardiology
Background:
- Coronavirus disease 2019 (COVID-19) is a global health crisis.
- Increased arterial and venous thrombosis observed in COVID-19 patients.
- Thromboembolic complications represent a significant concern in hospitalized COVID-19 cases.
Purpose of the Study:
- To characterize thromboembolic complications in hospitalized COVID-19 patients.
- To compare outcomes between intensive care unit (ICU) and general ward patients.
- To identify risk factors and prognostic impact of thromboembolic events.
Main Methods:
- Prospective, single-center study.
- Comparison of patient characteristics, risk factors, event rates, hospital stay, and mortality.
- Inclusion of patients admitted to ICU or general ward.
Main Results:
- Global thromboembolic event rate was 4.4%, significantly higher in ICU patients (29% vs. 1.4%).
- Independent predictors for thromboembolic events included age, D-dimer, and creatinine.
- Overall mortality was 4.3%, with significantly higher rates in ICU patients (29% vs. 1.3%).
Conclusions:
- Hospitalized COVID-19 patients exhibit a high incidence of thromboembolic events, even with heparin prophylaxis.
- Thromboembolic complications are associated with poorer prognosis and increased mortality, especially in ICU settings.
- Age, D-dimer, and creatinine levels are key predictive factors for these complications.
Abstract:
Coronavirus disease-19 has emerged as a devastating global public health crisis. An increased frequency of arterial and venous thrombosis was observed in COVID-19 infection. The objective of this study was to describe the thromboembolic complications of patients hospitalized for COVID-19 and their evolution. A prospective single-center study was conducted that compared the characteristics, risk factors, thromboembolic event rate, hospital stay and mortality among patients admitted to intensive care or general ward. The mean age of population was 46 ± 18 years, and 52% were female. The global rate of thromboembolic events was 4.4%, significantly higher in intensive unit patients (29% vs 1.4%; p < 0.001) despite the high use of prophylactic heparin (91.1% vs. 84.9%; p < 0.1). The independent predictive factors for the development of thromboembolic events were: age, D-dimer and creatinine. Of the patients admitted to intensive care, 45.1% required mechanical ventilation. Overall mortality was 4.3%, significantly higher in intensive care patients than in the general hospital ward (29% vs. 1.3%; p < 0.0001). Patients requiring hospitalization due to infection secondary to COVID-19 have a high rate of thromboembolic events despite the use of thromboprophylaxis with heparin, generating a negative prognostic impact on the survival of patients admitted to intensive care.
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