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Risk Factors for Postdischarge Major Thromboembolism and Mortality in Hospitalized Patients with COVID-19 with

Dimitrios Giannis1,2,3,4, Mark Goldin1,3,4, Husneara Rahman1,4

  • 1Institute of Health Systems Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York, United States.

Thrombosis and Haemostasis
|May 5, 2023
PubMed

Insights

COVID-19 patients with cardiovascular disease face high risks of arterial or venous thromboembolism and death post-discharge. Advanced age, peripheral artery disease, and ICU admission are key risk factors.

Area of Science:

  • Cardiovascular Medicine
  • Infectious Diseases
  • Thrombosis Research

Background:

  • Coronavirus disease 2019 (COVID-19) is linked to increased risks of venous and arterial thromboembolism (VTE and ATE) and all-cause mortality (ACM) in hospitalized patients.
  • High-quality data on postdischarge outcomes for COVID-19 patients with pre-existing cardiovascular disease (CVD) are crucial.

Purpose of the Study:

  • To analyze postdischarge outcomes, including ATE, VTE, and ACM, in hospitalized COVID-19 patients with baseline CVD.
  • To identify independent risk factors associated with these adverse outcomes in this high-risk subgroup.

Main Methods:

  • A cohort of 608 hospitalized COVID-19 patients with CVD (coronary artery disease, carotid artery stenosis, peripheral artery disease, or ischemic stroke) was investigated.
  • Postdischarge rates of ATE, VTE, and ACM were analyzed up to 90 days.
  • Multivariate analysis was employed to identify significant risk factors for a composite endpoint of ATE, VTE, or ACM.

Main Results:

  • The 90-day postdischarge rates were: ATE 27.3%, VTE 6.9%, and a composite of ATE, VTE, or ACM in 35.2% of patients.
  • Significant independent risk factors for the composite endpoint included age >75 years, peripheral artery disease (PAD), carotid artery stenosis (CAS), congestive heart failure (CHF), previous VTE, and intensive care unit (ICU) admission.

Conclusions:

  • Hospitalized COVID-19 patients with underlying cardiovascular disease exhibit elevated rates of ATE, VTE, or ACM within 90 days after discharge.
  • Key independent risk factors identified are older age (>75 years), PAD, CAS, CHF, prior VTE, and ICU admission, highlighting the need for targeted management strategies.
Abstract

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