Predictors of thrombotic events in patients with post-COVID condition

Abstract

Introduction. COVID-19 induces a procoagulant state, which can lead to various thrombotic and thromboembolic complications, however, there are just a few studies and papers devoted to COVID-19 long-term thrombotic complications. Purpose. To assess COVID-19, that was experienced more than 12 weeks ago, as a risk factor for developing arterial and venous thrombotic events in the setting of Vascular Surgery Department of N. V. Sklifosovsky Research Institute for Emergency Medicine. Materials and Methods. The study included 145 patients, 83 (57.2 %) were male, 62 (42.8 %) were female. Mean age of men was 65.0 [57.0; 72.0] years, mean age of women – 73.5 [62.3; 82.0] years (p = 0.003); 84 patients (57.9 %) were older than 65 years. 19 patients (13.1 %) were diagnosed with pulmonary embolism, 79 (54.5 %) with arterial thrombosis of mixed genesis, 46 (31.7 %) with venous thrombosis, 18 (12.4 %) were diagnosed with thrombophlebitis. In the group of patients with history of COVID-19 12 or more weeks ago 45 (58.44 %) were taking antithrombotic medications. The most common comorbidities were arterial hypertension (83.44 %), chronic kidney disease (82.06 %) and coronary artery disease (62.06 %). Results. A statistically significant mean correlation was found between anti-SARS-CoV-2 IgG and hemoglobin (r = –0,326; p = 0,006) and between anti-SARS-CoV-2 IgG and glomerular filtration rate (r = –0,300; p = 0,010). COVID-19, that was experienced 12 and more weeks ago, is not a statistically significant predictor of arterial (OR = 1.01; 95 % CI: 0.552–1.940; p = 0.987) and venous (OR = 0.733; 95 % CI: 0.364–1.479, p = 0.386) thrombotic events. Main risk factors for developing thrombotic events in those patients were comorbidities and predisposing factors: arterial hypertension (OR = 6.923; 95 % CI: 1.3842–34.630; p = 0.018), coronary artery disease (OR = 9.867; 95 % CI: 3.1272–31.1310; p < 0.001), atrial fibrillation (OR = 3.875; 95 % CI: 1.141–13.170; p = 0.030), and smoking (OR = 5.855; 95 % CI: 1.201–28.550; p = 0.029). Conclusion. Alone, COVID-19, that was experienced more than 12 weeks ago, as not a strong predictor of developing arterial and venous thrombotic events. However, in patients with comorbidities, such as arterial hypertension, coronary artery disease and atrial fibrillation, and in presence of predisposing modifying lifestyle factors, such as smoking, there is a statistically significant risk of various thrombotic events.