COVID-19 predisposes patients to a higher risk of venous thromboembolism (VTE), although the extent of these implications is unclear and the risk of bleeding has been poorly evaluated. To date, no studies have reported long-term outcomes of patients with COVID-19 and VTE.
Prospective observational study to evaluate long-term (90 days or more) outcomes of patients diagnosed with VTE (PE, DVT of the extremities or both) in the setting of COVID-19. The main outcome of the study was a compound of major bleeding and death.
the study comprised 100 patients (mean age 65 +/-13.9 years). At the time of VTE diagnosis, 66% patients were hospitalized, 34.8% of them in the ICU. Mean follow-up was 97.9 +/-23.3 days. During the study period 24% patients died and median time to death was 12 (IQR: 2.25-20.75) days, 11% patients had major bleeding and median time to event was 12 (IQR: 5-16) days. The cause of death was PE in 5% and bleeding in 2% of patients. There were no VTE recurrences. The main study outcome occurred in 29% patients. Risk of death or major bleeding were independently associated with ICU admission (HR 12.2; 95% CI 3.0-48.3), thrombocytopenia (HR 4.5; 95% CI 1.2-16.5) and cancer (HR 21.6; 95% CI 1.8-259).
In patients with COVID-19 and VTE, mortality and major bleeding were high and almost a third of deaths were VTE-related. The majority of complications occurred in the first 30 days. ICU admission, thrombocytopenia and cancer are risk factors for poor prognosis.
About The Expert
Pablo Demelo-Rodríguez
Lucía Ordieres-Ortega
Zichen Ji
Jorge Del Toro-Cervera
Javier de Miguel-Díez
Luis Antonio Álvarez-Sala-Walther
Francisco Galeano-Valle
References
PubMed