ORIGINAL ARTICLE  MISCELLANEOUS 

International Angiology 2022 August;41(4):356-63

DOI: 10.23736/S0392-9590.22.04845-3

Copyright © 2022 EDIZIONI MINERVA MEDICA

language: English

The incidence and clinical impact of thrombotic events in hospitalized COVID-2019 illness

Bhupinder SINGH ¹ ✉, Harmeet P. DHOORIA ², Bishav MOHAN ³, Abhishek GOYAL ³, Gurbhej SINGH ³, Parampratap SINGH ³, Mayur GOYAL ³, Suraj LUTHRA ³, Shibba T. CHHABRA ³, Rohit TANDON ³, Naved ASLAM ³, Gurpreet S. WANDER ³

¹ Department of Cardiology, All India Institute of Medical Sciences, Bathinda, India; ² Department of Medicine, Dayanand Medical College and Hospital, Tagore Nagar, India; ³ Department of Cardiology, Dayanand Medical College and Hospital, Tagore Nagar, India

BACKGROUND: Coronavirus disease-2019 (COVID-19) infection and thrombosis are of great clinical importance as this association has shown to increase mortality. We intend to estimate the incidence of thrombotic events (TE) and their impact on clinical outcomes in hospitalized COVID-19 patients.
METHODS: This was an analytical cross-sectional study. The study population comprised of hospitalized COVID-19 patients between 1^st March 2021 and 31^st May 2021. The clinico-demographic data, thrombotic events, and clinical outcomes were collected from electronic health records.
RESULTS: A total of 1274 patients were analyzed. The median age of the study population was 56 years (IQR: 44-66 years). The estimated incidence of TE was 5.8% (N.=74); 60.8% of these TE occurred in patients having severe/critical COVID-19 illness and 70.3% of TE occurred in patients in the intensive care unit. Venous events (3.9%) were common compared to arterial events(1.9%). On multivariate logistic regression analysis, total leukocyte count, C-reactive protein, and D-dimer level were found to be the independent predictors of having TE. Receiver operator curve revealed a cut-off point of 872.5 DDU µg/L for D-dimer level (sensitivity: 67.6% and specificity: 72.1%; P<0.001, area under curve 0.78) for predicting TE. Patients with TE had significantly higher mortality compared to those without TE (58.1% vs. 22.2%; P<0.001); and the presence of TE (OR=2.94; 95% CI:1.7-5.1, P<0.001) was found to be the independent predictor of mortality.
CONCLUSIONS: The incidence of TE is high for hospitalized COVID-19 patients and it is even higher in severe/critical COVID illness. Its presence has shown to double the mortality compared to those without it.

KEY WORDS: COVID-19; Thrombosis; Incidence; Risk factors; Mortality