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Hemodynamic and Clinical Predictors of Thrombolysis in Post-COVID Venous Thromboembolism: A Retrospective Cohort

Giulia-Mihaela Cojocaru1, Antoniu Octavian Petriş2,3, Alin-Constantin Pînzariu4

  • 1Faculty of Medicine, Doctoral School of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania.

Biomedicines
|September 27, 2025
PubMed

Insights

Simple clinical factors like reduced TAPSE, SpO2, and LVEDD can predict severe post-COVID venous thromboembolism (VTE) requiring thrombolysis. This helps identify high-risk patients for timely intervention.

Area of Science:

  • Cardiology
  • Pulmonology
  • Infectious Diseases

Background:

  • Post-acute venous thromboembolism (VTE) is a significant complication of COVID-19.
  • Persistent endothelial dysfunction and thromboinflammation contribute to VTE development.
  • Simple clinical predictors are needed to optimize VTE management in COVID-19 survivors.

Purpose of the Study:

  • To identify simple clinical and echocardiographic predictors of VTE in post-COVID-19 patients.
  • To develop a pragmatic risk-stratification approach for VTE in this population.
  • To assess the association between clinical parameters and the need for systemic thrombolysis.

Main Methods:

  • Retrospective cohort study of 54 adults with COVID-19 and VTE.
  • Collected demographic, comorbidity, laboratory, and echocardiographic data.
  • Key echocardiographic variables included TAPSE, SpO2, and LVEDD.

Main Results:

  • Reduced TAPSE (13.0 mm), SpO2 (90.1%), and LVEDD (24.4 mm) were significantly associated with thrombolysis.
  • Each 1 mm decrease in TAPSE increased thrombolysis likelihood by 1.58 (aOR).
  • Each 1% decrease in SpO2 increased thrombolysis likelihood by 1.34 (aOR).

Conclusions:

  • Reduced TAPSE, SpO2, and LVEDD are key indicators of hemodynamic compromise in post-COVID VTE.
  • These parameters can identify patients requiring systemic thrombolysis.
  • Point-of-care assessment using these variables may enhance early risk stratification and guide treatment decisions.

Keywords:
COVID-19SpO2TAPSEVTEechocardiographypost-COVID syndromepulmonary embolismthrombolysis

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