Despite of having fewer clinical risk factors for venous thromboembolism (VTE) and receiving greater doses of anticoagulant medication, patients with COVID-19 had higher incidence of in-hospital VTE and higher mortality rate than patients who were hospitalized for other conditions, according to the results of a single-center study presented at the International Society on Thrombosis and Haemostasis (ISTH) 2021 Virtual Congress.
The findings provide additional evidence that the novel coronavirus SARS-CoV-2 induces a state of hypercoagulability in patients with COVID-19.
Between January 2020 and February 2021, the investigators retrospectively analyzed electronic medical records of all confirmed cases of VTE (both pulmonary embolism and/or deep vein thrombosis) at a hospital in Rio de Janeiro, Brazil, including VTE diagnosed at admission, during hospitalization, or at readmission to the hospital within 90 days after discharge. They compared risk factors, prophylaxis regimens, laboratory data, and incidence and mortality rates of VTE in patients with and without COVID-19.
Overall, 177 patients experienced VTE events. The average age was 62.9 years (range, 16-103). Most patients (85%) were critically ill. Among all patients with VTE events, 38.4% had confirmed COVID-19 (n=68), while the non-COVID group comprised 61.5% of patients (n=109).
Patients with COVID-19 were predominantly male (78% vs 55%; P =.002), of older age (66 vs 61 years; P =.034), and had fewer clinical risk factors for VTE than patients without COVID-19. Despite receiving greater doses of enoxaparin, patients with COVID-19 had higher incidence of VTE during hospitalization than patients without COVID-19 (50% vs 18%; P <.0001). They also had higher D-dimer levels (P =.004) than patients without COVID-19, but the 2 groups had similar levels of C-reactive protein (P =.892).
When considering only patients who were critically ill, patients with COVID-19 were 11 times more likely to have VTE events than patients without COVID-19 (5.6% vs 0.5%; unadjusted odds ratio, 10.98; 95% CI, 6.3-19.2; P <.00001]), and mortality rate was higher in patients with COVID-19 compared with patients without COVID-19 (38.2% vs 5.5%; P <.0001).
Chindamo MC, Manhaes MB, Carvalho LD, et al. Differences of venous thromboembolism (VTE) events in COVID-19 and non-COVID-19 hospitalized patients. Paper presented at: International Society on Thrombosis and Haemostasis (ISTH) 2021 Congress; July 17-21, 2021; virtual. Abstract PB0191.