Abstract
Introduction: COVID-19 predisposes patients to a higher risk of venous thromboembolism (VTE), although the extent of these implications is unclear and the risk of bleeding has been poorly evaluated. To date, no studies have reported long-term outcomes of patients with COVID-19 and VTE.
Method: Prospective observational study to evaluate long-term (90 days or more) outcomes of patients diagnosed with VTE (PE, DVT of the extremities, or both) in the setting of COVID-19. The main outcome of the study was a compound of major bleeding and death.
Results: The study comprised 100 patients (mean age 65 ± 13.9 years). At the time of VTE diagnosis, 66% patients were hospitalized, 34.8% of them in the ICU. Mean follow-up was 97.9 ± 23.3 days. During the study period, 24% patients died and median time to death was 12 (IQR: 2.25-20.75) days, 11% patients had major bleeding and median time to event was 12 (IQR: 5-16) days. The cause of death was PE in 5% and bleeding in 2% of patients. There were no VTE recurrences. The main study outcome occurred in 29% patients. Risk of death or major bleeding was independently associated with ICU admission (HR 12.2; 95% CI 3.0-48.3), thrombocytopenia (HR 4.5; 95% CI 1.2-16.5), and cancer (HR 21.6; 95% CI 1.8-259).
Conclusion: In patients with COVID-19 and VTE, mortality and major bleeding were high and almost a third of deaths were VTE-related. The majority of complications occurred in the first 30 days. ICU admission, thrombocytopenia, and cancer are risk factors for poor prognosis.
Keywords: COVID-19; SARS-COV-2; anticoagulation; bleeding; venous thromboembolism.
【저자키워드】 COVID-19, SARS-CoV-2, anticoagulation, Venous Thromboembolism, bleeding, 【초록키워드】 Hospitalized, Mortality, Cancer, Diagnosis, risk, outcome, risk factor, Venous Thromboembolism, ICU, Prospective, Patient, ICU admission, death, Complication, age, Follow-up, patients, DVT, VTE, higher risk, 95% CI, median time, study period, poor prognosis, major bleeding, implication, evaluate, occurred, reported, diagnosed, evaluated, majority, patients died, patients with COVID-19, 【제목키워드】 risk factor, Venous Thromboembolism, Patient, death, Follow-up, major bleeding,