Background
Venous thromboembolism (VTE) in coronavirus disease 2019 (COVID-19) has been established. We sought to evaluate the clinical impact of thrombosis in COVID-19–positive patients over the span of the pandemic to date.
Methods
We analyzed COVID-19–positive patients with the diagnosis of thrombosis who presented to the MedStar Health system (11 hospitals in Washington, DC and Maryland) during the pandemic (March 1, 2020 to March 31, 2021). We compared clinical course and outcomes based on the presence or absence of thrombosis and then cardiac thrombosis specifically.
Results
The cohort included 11,537 COVID-19–positive admitted patients. Of these patients, 1,248 had noncardiac thrombotic events (VTE or stroke), and 1,009 patients had cardiac thrombosis (myocardial infarction) during their hospital admission. In the thrombosis arm, the cohort’s mean age was 64.5 ± 15.3 years, 53.3% were men and the majority African American (64.9%). Patients with thrombosis tended to be older, with more comorbidities. White blood cell count, creatinine, C-reactive protein, lactate dehydrogenase, and ferritin were all significantly higher in the thrombosis cohort compared with those patients without thrombosis. In-hospital mortality was significantly higher (16.0%) in COVID-19–positive patients with concomitant thrombosis than those without thrombosis (7.9%; P <0.001) but less compared with COVID-19– positive patients with cardiac thrombosis (24.7%; P <0.001; Figure 1).
Conclusion
Patients with COVID-19 and thrombosis are at higher risk for in-hospital mortality. However, this prognosis is not as grim as cardiac thrombosis. Efforts should focus on early recognition, evaluation, and intensifying care of these patients.
Categories
ENDOVASCULAR: Pulmonary Embolism and Pulmonary Hypertension