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A Multicenter Cohort Study of COVID-19 Associated Venous Thromboembolism in Admitted Patients Followed Longitudinally 3-Months After Discharge

1University of British Columbia, Vancouver, British Columbia, Canada, 2Division of Hematology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada, 3Division of Critical Care Medicine, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada, 4Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada, 5Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada, 6Division of Respiratory Medicine, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada, 7Division of General Internal Medicine, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada

Abstract Number: PB0051

Meeting: ISTH 2022 Congress

Theme: COVID and Coagulation » COVID and Coagulation, Clinical

Background: The incidence of venous thromboembolism (VTE) in patients with COVID-19 during hospitalization and in the post-discharge setting has been reported with wide variability. Many studies have short follow-up, reported the early phase of the pandemic, or did not report bleeding or anticoagulant dosing.

Aims: We determined the incidence of symptomatic VTE and bleeding in patients admitted to hospital for COVID-19 and their 3-month risk of VTE post-discharge.

Methods: All patients admitted for COVID-19 at 5 regional hospitals were identified between January 1 and December 31, 2020. Data were collected from their hospital admission and for a minimum of 3 months post-discharge. Re-admissions during this period were considered as post-discharge data of the index admission. Standard thromboprophylaxis for critical care and ward patients were enoxaparin 30 mg twice daily or 40 mg once daily. Post-discharge thromboprophylaxis was not given. Patient consent was waived by the institutional research ethics board.

Results: A total of 565 patients were included. Baseline demographics are reported in Table 1. Median length-of-stay was 9.0 days (range 5-131). 178 patients (31.5%) required critical care support and 79 patients (14%) died during index admission. 25 patients (4.4%) had VTE during hospitalization, of which 17 occurred within first two weeks and none occurred in those on therapeutic anticoagulation. There were no fatal bleeds. 5 patients (0.88%) developed critical site bleeding. Patient characteristics, anticoagulant use and bleeding rates during hospitalization are reported in Table 2. Among 486 discharged patients, median length of follow-up was 163 days (range 3-600): 63.5% had at least 90 days of follow-up data and 18.7% were lost to follow-up. 5 patients (1.3%) had symptomatic VTE diagnosed within 3 months after discharge.

Conclusion(s): The in-hospital incidence of VTE in COVID-19 was lower but post-discharge incidence was higher than other studies. Therapeutic anticoagulation appeared protective against symptomatic VTE.

Table

Table 1: Baseline Demographics

Table

Table 2: Critical care and oxygen requirements, Anticoagulant use and Bleeding

To cite this abstract in AMA style:

Drury C, Lai C, Misselbrook G, Al Zaki A, Bhangu G, Conroy M, Eadie L, Kumar D, Li C, Manhas D, Singh N, Yuan J, Lee A, Wan T. A Multicenter Cohort Study of COVID-19 Associated Venous Thromboembolism in Admitted Patients Followed Longitudinally 3-Months After Discharge [abstract]. https://abstracts.isth.org/abstract/a-multicenter-cohort-study-of-covid-19-associated-venous-thromboembolism-in-admitted-patients-followed-longitudinally-3-months-after-discharge/. Accessed September 29, 2023.

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