The Risk Of Thromboembolic Events In COVID-19 Patients During The Height Of The SARS-CoV-2 Pandemic

Abstract

INTRODUCTION/OBJECTIVESCOVID-19 is associated with a prothrombotic state and elevated risk of thromboembolism. This study assesses the risk of thromboembolic events and their impact on hospitalization of COVID-19 inpatients.Image, table 1Image, table 1Image, table 1METHODSRetrospective review of all COVID-19 inpatients (≥18 years old) at a single academic institution from March 15, 2020 - July 1, 2020 was performed. Patient data included demographics, comorbidities, hospital admission type, thromboembolic events, laboratory values, use of anticoagulants/antiplatelets, hospital length of stay, and mortality.RESULTSWithin 826 COVID-19 inpatients (56% male, 44% female) identified, 87 patients (10.5%) had 98 thromboembolic events. (Table 1). Hypertension, CAD, and CLTI were associated with increased incidence of thromboembolism (p <0.05). Non-white patients had higher incidence of thromboembolism [OR (CI): 2.43 (1.279, 4.616), p=0.007]. As D-dimer increased by 500 unit increments, the odds of developing a thromboembolic event increased by 5.2% [OR (CI): 1.052 (1.027, 1.077), p<0.001]. (Table 2). Patients with thromboembolism had higher antiplatelet/anticoagulants usage (p <.05), longer hospital LOS (Mean: 17.8 vs 9.0, p <0.001), higher ICU admission (63% vs 33%, p<0.001), and higher in-hospital mortality (28% vs 16%, p =0.006). (Table 3).CONCLUSIONSIncreased D-dimer, CAD, and CLTI are associated with elevated risk of thromboembolic events in hospitalized COVID-19 patients while smoking status had no association. Non-white patients had increased risk of thromboembolism. Patients with thromboembolism had higher antiplatelet/anticoagulant usage, longer LOS, higher ICU admissions, and increased mortality.Image, table 1Image, table 1