Clotting events among hospitalized patients infected with COVID-19 in a large multisite cohort in the United States

PLoS One. 2022 Jan 5;17(1):e0262352. doi: 10.1371/journal.pone.0262352. eCollection 2022.

Abstract

Introduction: COVID-19 infection has been hypothesized to precipitate venous and arterial clotting events more frequently than other illnesses.

Materials and methods: We demonstrate this increased risk of blood clots by comparing rates of venous and arterial clotting events in 4400 hospitalized COVID-19 patients in a large multisite clinical network in the United States examined from April through June of 2020, to patients hospitalized for non-COVID illness and influenza during the same time period and in 2019.

Results: We demonstrate that COVID-19 increases the risk of venous thrombosis by two-fold compared to the general inpatient population and compared to people with influenza infection. Arterial and venous thrombosis were both common occurrences among patients with COVID-19 infection. Risk factors for thrombosis included male gender, older age, and diabetes. Patients with venous or arterial thrombosis had high rates of admission to the ICU, re-admission to the hospital, and death.

Conclusion: Given the ongoing scientific discussion about the impact of clotting on COVID-19 disease progression, these results highlight the need to further elucidate the role of anticoagulation in COVID-19 patients, particularly outside the intensive care unit setting. Additionally, concerns regarding clotting and COVID-19 vaccines highlight the importance of addressing the alarmingly high rate of clotting events during actual COVID-19 infection when weighing the risks and benefits of vaccination.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • COVID-19 / mortality
  • COVID-19 / pathology*
  • Cohort Studies
  • Comorbidity
  • Female
  • Hospitalization
  • Humans
  • Male
  • New Jersey
  • Retrospective Studies
  • Thrombosis / mortality
  • Thrombosis / pathology*
  • United States

Grants and funding

The authors received no specific funding for this work.