Low Incidence of Symptomatic Thrombotic Events in Adult Patients Hospitalized with Coronavirus 19: A Retrospective Cohort Study

Clin Appl Thromb Hemost. 2021 Jan-Dec:27:10760296211051712. doi: 10.1177/10760296211051712.

Abstract

Background: Since the beginning of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) pandemic, there have been many reports of increased incidence of venous thromboembolism and arterial events as a complication.

Objective: To determine the incidence of symptomatic thrombotic events (TEs) in patients hospitalized for SARS-CoV2 disease (coronavirus 19 [Covid-19]).

Methods: A retrospective single-center cohort study with adult patients with a positive reverse transcriptase-polymerase chain reaction (rt-PCR) for SARS-CoV2, included from the date of diagnosis of Covid-19 and followed for 90 days or until death.

Results: A total of 1621 patients were included in this study. The median age was 73 years (interquartile range25th-75th [IQR] 53-87 years) and 57% (913) were female. Overall mortality was 21.6% (348). The overall incidence of symptomatic TEs within 90 days of diagnosis was 1.8% (30 of 1621) occurring in 28 patients, including an incidence of pulmonary embolism of 0.9% (15, 95% confidence interval [CI] 0.60%-1.6%), deep venous thrombosis of 0.61% (10, 95% CI 0.2%-1%), ischemic stroke of 0.25% (4, 95% CI 0.09%-0.65%), and ischemic arterial events of 0.06% (1, 95% CI 0.008%-0.43%). No acute coronary syndrome events were recorded. The incidence of symptomatic TEs was significantly lower in the general ward than in intensive care units (1.2% vs 5.7%; p < .001). The median time since positive rt-PCR for SARS-CoV2 to symptomatic TE was 22.5 days (IQR 19-43 days). There was no significant difference in the proportion of patients receiving (53.6%) and not receiving thromboprophylaxis (66.5%) and the development of TEs.

Conclusion: The overall incidence of symptomatic TEs among these patients was lower than the incidence previously reported.

Keywords: Covid 19; deep venous thrombosis; pulmonary embolism; thrombosis.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Argentina / epidemiology
  • Arterial Occlusive Diseases / blood
  • Arterial Occlusive Diseases / diagnosis
  • Arterial Occlusive Diseases / epidemiology*
  • COVID-19 / blood
  • COVID-19 / diagnosis
  • COVID-19 / epidemiology*
  • Female
  • Humans
  • Incidence
  • Ischemic Stroke / blood
  • Ischemic Stroke / diagnosis
  • Ischemic Stroke / epidemiology
  • Male
  • Middle Aged
  • Patient Admission
  • Pulmonary Embolism / blood
  • Pulmonary Embolism / diagnosis
  • Pulmonary Embolism / epidemiology*
  • Retrospective Studies
  • Thromboembolism / blood
  • Thromboembolism / diagnosis
  • Thromboembolism / epidemiology*
  • Time Factors
  • Venous Thrombosis / blood
  • Venous Thrombosis / diagnosis
  • Venous Thrombosis / epidemiology*