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Thrombosis and Bleeding Risk Scores Are Strongly Associated with Mortality in Hospitalized Patients with COVID-19: A

Kunapa Iam-Arunthai1, Supat Chamnanchanunt1,2, Pravinwan Thungthong1

  • 1Division of Hematology, Department of Medicine, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok 10400, Thailand.

Journal of Clinical Medicine
|April 9, 2024
PubMed

Insights

Hospitalized COVID-19 patients with high thrombosis and bleeding risk scores face increased mortality. Risk scores effectively predict venous thromboembolism and death, but low molecular weight heparin use did not reduce VTE incidence in this study.

Area of Science:

  • Internal Medicine
  • Critical Care Medicine
  • Pharmacology

Background:

  • International guidelines recommend pharmacological prophylaxis for hospitalized COVID-19 patients.
  • Concerns exist regarding the efficacy and safety of anticoagulant use in this population.
  • This study evaluates the predictive value of thrombosis and bleeding risk scores for clinical outcomes in COVID-19 patients.

Purpose of the Study:

  • To investigate the association between established thrombosis and bleeding risk scores and clinical outcomes in hospitalized COVID-19 patients.
  • To assess the impact of these scores on venous thromboembolism (VTE) and mortality.
  • To examine the effectiveness of low molecular weight heparin (LMWH) prophylaxis in relation to risk scores.

Main Methods:

  • Retrospective review of 160 adult COVID-19 patients admitted between 2021-2022.
  • Analysis of clinical data, laboratory results, LMWH use, VTE, bleeding events, and 30-day survival.
  • Stratification of patients based on Padua Prediction Score (PPS), IMPROVE_VTE, and IMPROVE_BRS scores.

Main Results:

  • High PPS and IMPROVE_VTE scores were significantly associated with increased VTE risk (30.8% vs. 9.0%, p=0.006 and 25.6% vs. 7.7%, p=0.006, respectively).
  • Elevated IMPROVE_VTE and IMPROVE_BRS scores correlated with higher mortality (HR 7.49 and 6.27, p<0.001).
  • LMWH prophylaxis did not demonstrate a reduced incidence of VTE when stratified by risk groups.

Conclusions:

  • COVID-19 patients with high thrombosis and bleeding risk scores exhibit a significantly higher mortality rate.
  • Risk stratification tools can identify high-risk patients for closer monitoring and tailored management.
  • Further research is needed to optimize anticoagulant strategies in hospitalized COVID-19 patients based on individual risk profiles.

Keywords:
COVID-19IMPROVE scorePadua prediction scoremortalityvenous thromboembolism

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