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Are Mild or Moderate COVID-19 Patients at Higher Risk of VTE? A Comparison of Two Prospective European Cohorts in Emergency Departments

1Emergency Department, Angers University Hospital, Angers, France, 2UNIV Angers, UMR MitoVasc CNRS 6015 - INSERM 1083. FCRIN, INNOVTE, Angers, France, 3UNIV Angers, Micro et Nano Médecines Translationnelles, MINT, UMR INSERM 1066, UMR CNRS 6021, Angers, France, 4Methodology and Biostatistics Department, Delegation to Clinical Research and Innovation, Angers University Hospital, Angers, France, 5Emergency Department, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Bruxelles, Belgium, 6CH Cholet, Cholet, France, 7EHESP, Irset, Inserm, UMR S1085, CAPTV CDC, University of Rennes, Angers, France, 8Department of Infectious Diseases, Angers University Hospital, Angers, France, 9CRCINA, Inserm, University of Nantes, UNIV Angers, Angers, France

Abstract Number: PB0173

Meeting: ISTH 2021 Congress

Theme: COVID and Coagulation » COVID and Coagulation, Clinical

Background: Severely ill patients with SARS-CoV-2 have at increased risk of venous thromboembolism (VTE). However, the VTE risk in patients with mild to moderate COVID-19 remains uncertain.

Aims: To assess the risk of VTE in patients with mild to moderate COVID-19 patients versus similar patients without COVID-19 and to define VTE risk factors in COVID-19 patients.

Methods: A prospective cohort of patients presented to ED for acute dyspnea or chest pain and having confirmed or probable mild to moderate COVID-19 was retrospectively compared to a prospective cohort of similar ED patients using propensity score matching. Patients having diagnostic testing for suspected PE and for whom PE was initially ruled-out were included. Univariate and multivariate analysis of possible VTE risk factors were performed in the COVID-19 patients. The main outcome was the rate of symptomatic VTE, deep venous thrombosis or pulmonary embolism, within the 28 days after ED presentation.

Results: A total of 2292 patients were included in the COVID-19 cohort and 1539 in the comparison cohort. After adjustment, the 28-day rate of symptomatic VTE was 1.87% (95%CI: 0.95 to 3.24) in the COVID-19 cohort and 0.18% (95%CI: 0.01 to 1.63) in the comparison cohort. The absolute difference was +1.69% (95%CI: 0.88 to 2.51, p< 0.001), +3.45% (95%CI: 1.80 to 5.11) in hospitalized patients and +0.50% (95%CI: 0.22 to 1.23) in patients treated at home. In the COVID-19 cohort, hospitalization and age > 65 years were independent risk factors of symptomatic VTE but not the lack of thromboprophylaxis.

Figure 1. Kaplan-Meier cumulative VTE rate for the primary outcome.

Conclusions: Patients with mild-to-moderate COVID-19 presenting to ED had a higher risk of subsequent VTE than similar patients, especially if they are older than 65 years and required hospitalization.

To cite this abstract in AMA style:

Douillet D, Riou J, Penaloza A, Moumneh T, Soulié C, Savary D, Morin F, Mahieu R, Roy P-. Are Mild or Moderate COVID-19 Patients at Higher Risk of VTE? A Comparison of Two Prospective European Cohorts in Emergency Departments [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/are-mild-or-moderate-covid-19-patients-at-higher-risk-of-vte-a-comparison-of-two-prospective-european-cohorts-in-emergency-departments/. Accessed November 29, 2023.

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