Table 1.
Table summarizing global incidence of venous and arterial thromboembolic disease in COVID-19.
| Location (first author) | Type of study | Sample size | Use of thromboprophylaxis | Venous thromboembolism incidence | Arterial thrombosis incidence | Key characteristics of patient population/other salient features of the study |
|---|---|---|---|---|---|---|
| Wuhan, China (Cui et al) | Retrospective; hospitalized patients | 81 | No | VTE 25%; all lower extremity thrombi | None | 41% patients had other comorbidity (HTN, DM, CAD) and 43% were smokers |
| Netherlands (Klok et al) | Retrospective; multicenter; hospitalized patients | 184 | Yes (nadroparin at different doses) | VTE (n = 28) 27%; of those PE (n = 25) was most common finding in 81% | Ischemic strokes (n = 3) 3.7% | 76% were male, 2.7% had active cancer and 9.2% were on therapeutic anticoagulation from prior. Mean age was 64 and mean weight was 87 kg |
| Netherlands (Middeldorp et al) | Retrospective; single center; hospitalized patients | 198 | Yes (nadroparin 2850 units daily for <100 kg and 5700 units daily for >100 kg) | 7-day incidence of VTE (15%) and 14-day incidence of VTE (34%) | None | The 7-day and 14-day incidence of VTE was higher in the ICU (25% and 48% respectively) than the general wards (6.5% and 10% respectively) |
| Italy (Lodigiani et al) | Retrospective; single center; hospitalized patients | 388 | Yes (LMWH) Ward: 75% used (41% prophylactic dose, 21% intermediate dose; 23% therapeutic dose) ICU: 100% used |
VTE 21% (cumulative rate) ICU 27.6% and general ward 6.6% |
Ischemic stroke 2.5% and ACS/MI 1.1% | 68% were male, 24.1% had BMI ≥ 30, 47.2% had HTN, 22.7% with DM, 11.6% smokers, 6.4% with active cancer and 3.1% with history of prior VTE. |
| France (Llitjos et al) | Retrospective study; 2 ICUs | 26 | Yes (31% with prophylactic dose and 69% with therapeutic dose) | VTE 69% | None | 77% were male, 85% had HTN, 27% consumed tobacco, median BMI 30.2 kg/m2; median D-dimer was 1750 ng/mL. 56% of patients on therapeutic dose and 100% on prophylactic dose had VTE. |
| France (Helms et al) | Prospective study; COVID-19 ARDS patients at 4 ICUs in 2 centers | 150 | Yes (LMWH) | PE 16.7%; DVT 2% | Ischemic stroke 1.3%; limb ischemia 0.7%; mesenteric ischemia 0.7% | Patients with COVID-19 ARDS had significantly higher thrombotic events, especially PE (11.7% vs. 2.1%, OR 6.2, p = 0.008) |
| France (Poissy et al) | Retrospective case series; ICU | 107 | Yes | PE (20.6%) | None | 59.1% were male, median age was 57, median BMI was 30. Incidence of VTE was 2×- higher than a historical control period |
| Netherlands (Beun et al) | Retrospective; ICU | 75 | Unknown | PE (26.6%; 21.3% subsegmental and 5.3% central); DVT 4% | Ischemic stroke 2.7% | 4 patients had heparin resistance apparent by PTT based methods probably due to elevated factor VIII levels |
| New York, USA (Oxley et al) | Case series | 5 | No | None | Ischemic stroke 5 young patients in 2 week period | All patients were < 50 years of age. Historical incidence was 0.73 patients in a 2 week period |
| Beijing, China (Zhang et al) | Case series | 3 | Unknown | None | Ischemic strokes in 3 patients | Age 65-70, 2/3 were male, all with cardiovascular comorbidities including 2/3 with history of ischemic stroke. All with anti-phospholipid antibodies |
| Italy (Bellosta et al) | Observational cohort study | 20 | 25% were on anticoagulation at baseline due to atrial fibrillation | None | Acute limb ischemia in 20 patients (16.3%) | 90% patients were male, mean age was 75 years, 55% had HTN. Incidence increased at 16.3% compared with a baseline rate of 1.8% in this region |
DVT = deep venous thrombosis.
PE = pulmonary embolism.
LMWH = low molecular weight heparin.