Table 3.
Comparison of survivors and non-survivors of COVID-19-associated thrombotic events.
| Patient characteristics | Survivors (n = 58) | Non-survivors (n = 11) | Univariate analysis |
Multivariate analysis |
|
|---|---|---|---|---|---|
| p value | OR (95% CI) | p value | |||
| Demographics | |||||
| Age, years, median (IQR) | 64.5 (55–74.5) | 71 (60–78) | 0.22 | ||
| Ethnicity, n (%) | |||||
| Caucasian | 45 (78) | 9 (82) | 0.8 | ||
| Hispanic | 13 (22) | 2 (18) | 0.8 | ||
| Male gender, n (%) | 37 (64) | 8 (73) | 0.73 | ||
| Cardiovascular risk factors | |||||
| Hypertension, n (%) | 30 (52) | 6 (55) | 0.86 | ||
| Diabetes, n (%) | 9 (16) | 4 (36) | 0.1 | ||
| Dyslipidemia, n (%) | 14 (24) | 4 (36) | 0.65 | ||
| Obesity, n (%) | 3 (5) | 1 (9) | 0.67 | ||
| Smoking, n (%) | 9 (15) | 2 (18) | 0.18 | ||
| Venous thrombotic risk factors | |||||
| Previous VTE, n (%) | 2 (3) | 0 | 1 | ||
| Active cancer, n (%) | 5 (9) | 0 | 1 | ||
| Chronic medical conditions | |||||
| Prior stroke/transient ischemic attack, n (%) | 4 (7) | 1 (9) | 0.19 | ||
| Ischemic heart disease, n (%) | 7 (12) | 1 (9) | 0.4 | ||
| LVEF <40%, n (%) | 0 | 0 | – | ||
| Chronic obstructive pulmonary disease, n (%) | 10 (17) | 0 | 0.34 | ||
| Chronic kidney disease, n (%) | 1 (2) | 0 | 1 | ||
| Baseline medications | |||||
| RAAS inhibitors, n (%) | 23 (40) | 6 (55) | 0.5 | ||
| Statins, n (%) | 16 (27) | 5 (45) | 0.12 | ||
| Hospitalization | |||||
| Initial COVID-19 symptoms to thrombotic event, days, median (IQR) | 18.1 (11–24) | 10.1 (1–14) | 0.02 | ||
| Thrombotic event diagnosis at the time of admission, n (%) | 4 (7) | 1 (9) | 0.19 | ||
| Laboratory tests | |||||
| Platelet counta, cells ×103/mm3, median (IQR) | 288 (204–377) | 262 (203–407) | 0.78 | ||
| Peak D-dimer, μg/L, median (IQR) | 11,395 (4,640–28,740) | 27,350 (7,610–60,190) | 0.15 | ||
| ISTH DIC scorea, mean (SD) | 1.66 (1.33) | 2.56 (1.5) | 0.036 | 6.96 (0.93–52.2) | 0.0589 |
| Pre-event ISTH DIC score, mean (SD) | 2.79 (0.97) | 3.25 (0.46) | 0.06 | ||
| ISTH DIC score incrementb, mean (SD) | 1.16 (1.26) | 1.43 (1.51) | 0.6 | ||
| Peak Troponin-T, ng/mL, median (IQR) | 0.02 (0.016–2.35) | 0.52 (0.03–2.39) | 0.29 | ||
| Creatininea, mg/dL, median (IQR) | 0.88 (0.7–1.1) | 0.98 (0.6–1.3) | 0.64 | ||
| Pre-event IL-6, pg/mL, median (IQR) | 66 (115–172) | 151 (64–274) | 0.34 | ||
| Pre-event Ferritin, ng/mL, median (IQR) | 677 (419–1,087) | 687 (360–865) | 0.84 | ||
| Pre-event CRP, mg/L, median (IQR) | 29 (4–57) | 49 (31–199) | 0.038 | 4.78 (0.62–36.8) | 0.132 |
| Treatment | |||||
| Pre-event LMWH prophylactic dose, n (%) | 53 (91) | 8 (73) | 0.08 | ||
| Pre-event LMWH therapeutic dosec, n (%) | 1 (2) | 1 (9) | 0.24 | ||
| Hydroxychloroquine, n (%) | 57 (98) | 10 (91) | 1 | ||
| Azithromycin, n (%) | 54 (93) | 10 (91) | 0.6 | ||
| Tocilizumab, n (%) | 28 (48) | 6 (55) | 0.73 | ||
| Corticosteroids, n (%) | 39 (67) | 9 (82) | 0.25 | ||
| Thrombotic event subtype | |||||
| Arterial, n (%) | 11 (19) | 8 (73) | < 0.001 | 18.79 (2.48–142) | 0.0045 |
| Venous, n (%) | 42 (72) | 1 (9) | |||
| Arterial and venous, n (%) | 4 (7) | 1 (9) | |||
| Microvascular, n (%) | 1 (2) | 1 (9) | |||
VTE: Venous thromboembolism. LVEF: Left ventricular ejection fraction. RAAS: Renin–Angiotensin–Aldosterone System. ISTH: International Society of Thrombosis and Haemostasis. DIC score: overt Disseminated Intravascular Coagulation score. IL-6: Interleukin 6. CRP: C reactive protein. LMWH: Low-molecular-weight heparin. Bold figures: statistically significant differences.
a
Initial laboratory investigation, on presentation.
b
ISTH DIC score increment: Pre-event score minus initial score.
c
As per described protocol or due to a precedent chronic condition requiring anticoagulation.