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Ir J Med Sci . The incidence of venous thromboembolism in critically ill patients with COVID-19 compared with critically ill non-COVID patients

tetano

Editor, Senior Moderator
Ir J Med Sci


. 2021 Jan 7.
doi: 10.1007/s11845-020-02503-0. Online ahead of print.
The incidence of venous thromboembolism in critically ill patients with COVID-19 compared with critically ill non-COVID patients


Sean Boyd[SUP] 1 [/SUP], Ignacio Martin-Loeches[SUP] 2 3 4 [/SUP]



Affiliations

Abstract

Background: COVID-19 is a novel coronavirus that is currently responsible for the global pandemic. It has been reported that up to 25% [1] of hospitalized patients with COVID-19 develop VTE (venous thromboembolism), and this can be as high as 31% in ICU patients with COVID-19 [2].
Aims: To determine VTE rates in ICU patients with COVID compared to those admitted with influenza and a control group.
Methods: We performed a retrospective chart review of 113 patients admitted to ICU at our hospital. Patient characteristics, comorbidities, coagulation profile and prevalence of radiologically proven VTE were recorded and compared between groups.
Results: More males than females were found in each group. When groups were compared the mean age, BMI and cigarette smoking were similar, as was the incidence of diabetes, chronic obstructive pulmonary disease and chronic kidney disease. aPTT was higher in the COVID-19 (30.9 ? 3.7 SD) vs (12.8 ? 4.1 SD) the influenza group vs (15.2 ? 4.1 SD) in controls p < 0.001, but fibrinogen was lower 6.2 ? 1.6 SD vs 34.6 ? 14.0SD vs 30.8 ? 5.0 SD, respectively, p < 0.001. VTE rates in the COVID (13.2%) (DVT 5.3%, PE 10.5%) and influenza groups (15.8%) (DVT 13.2%, PE 2.6%) were similar but were higher than the control group (8.1%) (DVT 8.1%, PE 2.7%), but not significantly so (p = 0.5).
Conclusions: ICU patients with COVID-19 displayed an abnormal coagulation profile and a VTE rate that is similar to ICU patients with influenza. VTE occurred despite thromboprophylaxis and remains a pertinent differential to keep in mind.

Keywords: COVID; DVT; Influenza; Invasive ventilation; PE; VTE.
 
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