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Venous thromboembolism in an Asian COVID-19 cohort across 3 infection waves-a retrospective observational study

Shir Ying Lee1,2,3, Winnie Z Y Teo2,4, Cheryl X Q Lim1,2

  • 1Division of Haematology, Department of Laboratory Medicine, National University Hospital, Singapore.

Research and Practice in Thrombosis and Haemostasis
|December 11, 2023
PubMed

Insights

Venous thromboembolism (VTE) risk in Asian COVID-19 patients is low overall but significantly higher in moderate to critical cases. Routine thromboprophylaxis is recommended for these higher-risk COVID-19 patients.

Area of Science:

  • Infectious Diseases
  • Hematology
  • Critical Care Medicine

Background:

  • COVID-19 is associated with a high incidence of venous thromboembolism (VTE), prompting international thromboprophylaxis recommendations.
  • Data on VTE in Asian COVID-19 patients are limited, creating uncertainty regarding the role of thromboprophylaxis in this population.

Purpose of the Study:

  • To determine the in-hospital incidence of VTE in Asian patients hospitalized with COVID-19.
  • To analyze VTE trends across different COVID-19 variants (wild-type, delta, omicron).
  • To identify risk factors associated with VTE in hospitalized COVID-19 patients.

Main Methods:

  • A retrospective observational cohort study included 3574 hospitalized adult COVID-19 patients from January 2020 to February 2022.
  • Objectively confirmed VTE events were reviewed to calculate incidence and trends.
  • Subset analysis stratified patients by infection severity (mild, moderate, critical) to assess risk factors and in-hospital VTE hazards.

Main Results:

  • The overall VTE incidence was 0.45% (16 events in 3574 patients), with incidences of 0.21% in mild, 3.60% in moderate, and 5.38% in critical COVID-19 infections.
  • Maximum cumulative VTE risk at 35 days was 11.55% for critical, 8.13% for moderate, and 1.14% for mild infections.
  • Infection severity was the strongest independent predictor of VTE; critical infection had a relative risk of 8.26 and moderate infection 6.29 compared to mild infection.

Conclusions:

  • VTE incidence in Asian COVID-19 patients remains below 1% across successive waves.
  • Patients with moderate and critical COVID-19 infections face a substantially elevated risk of VTE.
  • Routine thromboprophylaxis should be strongly considered for moderate and critical COVID-19 cases.
Abstract

Keywords:
AsianCOVID-19VTEincidencevenous thromboembolism

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