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Venous thromboembolism in COVID-19 patients and prediction model: a multicenter cohort study

Yi Lee1, Qasim Jehangir2, Pin Li3

  • 1Department of Medicine, St. Joseph Mercy Oakland Hospital, 44405 Woodward Avenue, Pontiac, MI, 48341, USA. olive.csmu@gmail.com.

BMC Infectious Diseases
|May 13, 2022
PubMed

Insights

COVID-19 patients face a high risk of venous thromboembolism (VTE), leading to longer hospital stays. A random forest model identified key predictors for VTE, aiding clinical decisions on anticoagulation.

Area of Science:

  • Medical research
  • Clinical informatics
  • Public health

Background:

  • COVID-19 infection is associated with an elevated risk of venous thrombosis.
  • Current anticoagulation strategies require further refinement through individualized risk assessment.
  • Identifying specific risk factors for venous thromboembolism (VTE) in COVID-19 patients is crucial for improved management.

Purpose of the Study:

  • To identify risk factors for VTE in hospitalized COVID-19 patients.
  • To develop a predictive model for VTE risk stratification.
  • To assist clinicians in VTE prevention and management decisions.

Main Methods:

  • A retrospective analysis of adult COVID-19 patients from four health systems in Southeast Michigan (March-December 2020).
  • Development and testing of four predictive models (random forest, logistic regression, multilinear regression, decision trees) for in-hospital VTE (deep vein thrombosis and pulmonary embolism).
  • Evaluation of model performance using ROC curve and confusion matrix; comparison of hospital and ICU length of stay between VTE and non-VTE groups.

Main Results:

  • 6.68% of 3531 COVID-19 admissions developed acute VTE.
  • Patients with VTE experienced significantly longer hospital (12.2 vs. 8.8 days) and ICU (3.8 vs. 1.9 days) stays.
  • The random forest model demonstrated superior performance, identifying blood pressure, electrolytes, renal function, hepatic enzymes, and inflammatory markers as key VTE predictors.

Conclusions:

  • COVID-19 patients exhibit a substantial risk of VTE, associated with prolonged hospitalization.
  • A random forest model effectively predicts VTE in COVID-19 patients.
  • The identified predictors can guide physicians in clinical judgment regarding anticoagulation therapy.
Abstract

Keywords:
AnticoagulationCOVID-19Deep vein thrombosisPulmonary embolismRisk predictionRisk stratificationVenous thromboembolism

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