Abstract 13924: Covid-19 Registry to Assess Frequency, Management, and Outcomes of Arterial and Venous Thromboembolic Complications (CORONA-VTE)

Abstract

Introduction: Cardiovascular complications, including myocardial infarction, ischemic stroke, and pulmonary embolism, represent an important source of adverse outcomes in COVID-19. Hypothesis: Arterial and venous thromboembolic complications are a common complication in COVID-19, especially in the cirtically ill and hospitalized populations. Methods: We analyzed a retrospective cohort of 1114 patients with COVID-19 diagnosed through our healthcare network. The total cohort was analyzed by site of care: intensive care (170 patients), hospitalized non-intensive care (229 patients), and outpatient (715 patients). The primary study outcome was a composite of adjudicated major arterial or venous thromboembolism. Results: Patients with COVID-19 were ethnically (22.3% Hispanic/Latinx) and racially (44.2% non-white) diverse. Cardiovascular risk factors of hypertension (35.8%), hyperlipidemia (28.6%), and diabetes (18.0%) were common. Prophylactic anticoagulation was prescribed in 89.4% of patients with COVID-19 in the intensive care cohort and 84.7% of those in the hospitalized non-intensive care setting. Frequencies of major arterial or venous thromboembolism, major cardiovascular adverse events, and symptomatic venous thromboembolism were highest in the intensive care cohort (35.3%, 45.9%, and 27.0 %, respectively) followed by the hospitalized non-intensive care cohort (2.6%, 6.1%, and 2.2%, respectively). The frequency of adverse events in the outpatient cohort was low. Conclusions: Major arterial or venous thromboembolism, major adverse cardiovascular events, and symptomatic venous thromboembolism occurred with high frequency in COVID-19, especially in the intensive care setting, despite a high utilization rate of thromboprophylaxis.