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Deep Vein Thrombosis in Hospitalized Patients with COVID-19: Incidence, Distribution, Predictors, and Clinical
Osmar Max Gonçalves Neves1, Guilherme Neves Lima2, Paula Santos Nunes3
1Doctoral Program in Bioscience and Health, University of Tiradentes, Aracaju, Sergipe, Brazil.
Insights
Deep vein thrombosis (DVT) is uncommon in hospitalized COVID-19 patients but linked to severe outcomes. Prior DVT history is the strongest predictor, suggesting targeted screening for high-risk individuals.
Area of Science:
- Cardiology
- Pulmonology
- Infectious Diseases
Background:
- COVID-19 is associated with an increased risk of venous thromboembolism.
- Understanding deep vein thrombosis (DVT) in hospitalized COVID-19 patients is crucial for risk stratification and management.
Purpose of the Study:
- To determine the incidence, anatomical location, and clinical predictors of DVT in COVID-19 patients.
- To analyze the association between DVT and clinical outcomes in this population.
Main Methods:
- Retrospective cohort study of 5,831 hospital admissions between 2020 and 2024.
- Analysis of demographic data, comorbidities, imaging, and clinical outcomes.
- Multivariable logistic regression to identify independent predictors of DVT.
Main Results:
- DVT was infrequent but associated with higher rates of ICU admission, mechanical ventilation, prolonged hospitalization, and mortality.
- Pulmonary embolism was more frequent in patients with DVT.
- Independent predictors included prior DVT, obesity, smoking, and oxygen requirement.
Conclusions:
- DVT in hospitalized COVID-19 patients, though uncommon, significantly increases morbidity and mortality.
- A history of venous thrombosis is the strongest predictor of DVT.
- Risk-adapted diagnostic strategies, including ultrasound, are needed despite prophylaxis.
Background:
This study aimed to assess the incidence, anatomical distribution, and independent clinical predictors of deep vein thrombosis (DVT) among patients hospitalized with COVID-19 in a Brazilian tertiary-care center.
Methods:
This retrospective cohort study included 5,831 hospital admissions (2020-2024) with complete DVT data. Demographic characteristics, comorbidities, imaging findings, and clinical outcomes were analyzed. Independent predictors of DVT were identified using multivariable logistic regression and reported as adjusted odds ratios (aORs).
Results:
DVT was infrequent but strongly associated with COVID-19 severity. Patients with DVT had higher rates of intensive care unit admission, mechanical ventilation, prolonged hospitalization (median 24 vs. 8 days; P < 0.001), and in-hospital mortality (37.7% vs. 11.1%; P < 0.001). Pulmonary embolism was more common among patients with DVT (15.9% vs. 1.2%; P < 0.001). Independent predictors of DVT included prior DVT (aOR = 18.3; 95% confidence interval [CI], 5.22-63.9), obesity (aOR = 3.21; 95% CI, 1.92-5.38), smoking (aOR 2.59; 95% CI, 1.26-5.34), and oxygen requirement (aOR = 4.86; 95% CI, 2.35-10.1). Most events were acute and predominantly involved the left lower extremity.
Conclusion:
Although uncommon, DVT in hospitalized COVID-19 patients was associated with substantial morbidity and mortality. A prior history of venous thrombosis was the strongest predictor, identifying a high-risk subgroup. The occurrence of clinically significant DVT despite routine pharmacological prophylaxis supports the need for risk-adapted diagnostic strategies, including targeted use of venous Doppler ultrasound.
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