Abstract Number: PB0270
Meeting: ISTH 2021 Congress
Theme: COVID and Coagulation » COVID and Coagulation, Clinical
Background: Thrombotic events that frequently occur in COVID-19 are predominantly venous thromboemboli (VTE) and are associated with increasing disease severity and worse clinical outcomes.
Aims: In this audit we sought to distinguish COVID-19 hospitalised patients with a VTE diagnosis over a period of 5 months (01/02/2020-30/06/2020). We recorded their intermediate-term management and clinical outcomes.
Methods: We identified 54 patients with a diagnosis of COVID and VTE (M/F:29/25, median age:68 (29-94) years. VTE was the presenting symptom on admission in 71% of patients. Pulmonary embolism was diagnosed in 92%, 15% required intensive care and 5.5% underwent thrombolysis.
Results: Following VTE diagnosis, 37 patients were treated with unfractionated heparin/enoxaparin while 16 (apixaban: 12, rivaroxaban: 4) were treated with direct anticoagulants (DOACs). 70% (38/54) patients recovered successfully; Upon discharge, 92% of patients were on DOACs (apixaban: 29, rivaroxaban: 5, edoxaban: 2) while only 2 continued enoxaparin. After a median follow up of 241 (0-350) days, 36 (66%) patients were alive. Most deaths (12/18) occurred within a week following admission, another 4 patients died within a month and they were 2 late deaths (on days +114 and +198). 14 patients had their anticoagulants stopped at 3 months while 9 patients remained on anticoagulation between 3 and up to 6 months. 12 patients received anticoagulation for >6 months with a clinical decision to offer lifelong anticoagulation cover in 8/12 patients. We recorded one VTE recurrence (2%) following anticoagulant discontinuation, one episode of major and one episode of minor bleeding. One patient developed pulmonary hypertension while post-COVID interstitial lung disease was diagnosed in 4 patients and 4 patients developed long COVID.
Conclusions: DOACs are safe and effective in COVID-related VTE. COVID is a complex clinical entity; In our patient cohort, 15% required lifelong anticoagulation following VTE.
To cite this abstract in AMA style:
Ahmed M, Khan R, Xenou E, Fowler M, Sinha S, Lokare A, Kartsios C. After the Storm; 6-month Follow up Outcomes and Management of COVID-19 Related Venous Thromboembolism [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/after-the-storm-6-month-follow-up-outcomes-and-management-of-covid-19-related-venous-thromboembolism/. Accessed April 19, 2024.« Back to ISTH 2021 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/after-the-storm-6-month-follow-up-outcomes-and-management-of-covid-19-related-venous-thromboembolism/