Abstract
Venous thromboembolism (VTE) has emerged as an important issue in patients with COVID-19. The purpose of this study is to identify the incidence of VTE and mortality in COVID-19 patients initially presenting to a large health system. Our retrospective study included adult patients (excluding patients presenting with obstetric/gynecologic conditions) across a multihospital health system in the New York Metropolitan Region from March 1-April 27, 2020. VTE and mortality rates within 8 h of assessment were described. In 10,871 adults with COVID-19, 118 patients (1.09%) were diagnosed with symptomatic VTE (101 pulmonary embolism, 17 deep vein thrombosis events) and 28 patients (0.26%) died during initial assessment. Among these 146 patients, 64.4% were males, 56.8% were 60 years or older, 15.1% had a BMI > 35, and 11.6% were admitted to the intensive care unit. Comorbidities included hypertension (46.6%), diabetes (24.7%), hyperlipidemia (14.4%), chronic lung disease (12.3%), coronary artery disease (11.0%), and prior VTE (7.5%). Key medications included corticosteroids (22.6%), statins (21.2%), antiplatelets (20.6%), and anticoagulants (20.6%). Highest D-Dimer was greater than six times the upper limit of normal in 51.4%. Statin and antiplatelet use were associated with decreased VTE or mortality (each p < 0.01). In COVID-19 patients who initially presented to a large multihospital health system, the overall symptomatic VTE and mortality rate was over 1.0%. Statin and antiplatelet use were associated with decreased VTE or mortality. The potential benefits of antithrombotics in high risk COVID-19 patients during the pre-hospitalization period deserves study.
Keywords: COVID-19; Outpatient; Thrombosis; Venous thromboembolism.
【저자키워드】 COVID-19, thrombosis, Venous Thromboembolism, Outpatient, 【초록키워드】 Corticosteroid, Mortality, intensive care, Lung disease, hypertension, Coronary artery disease, Retrospective study, Region, symptomatic, Patient, Thromboembolism, statin, mortality rate, incidence, health system, BMI, medication, New York, patients, Anticoagulant, antiplatelet, COVID-19 patient, VTE, high risk, Older, hyperlipidemia, limit, males, initial, greater, described, identify, died, diagnosed, events, potential benefit, presenting, conditions, diabete, patients with COVID-19, with COVID-19, 【제목키워드】 presentation,