Abstract Number: PB0178
Meeting: ISTH 2021 Congress
Theme: COVID and Coagulation » COVID and Coagulation, Clinical
Background: Previous evidence suggest that the thromboembolic risk is greater among patients with COVID-19 than those affected by other types of severe acute respiratory syndrome (SARS). However, such comparison has been mainly evaluated in historical cohorts.
Aims: To evaluate thromboembolic events in patients with COVID-19 and other SARS hospitalized in the same time period.
Methods: Consecutive patients hospitalized for SARS from March to May, 2020 were selected. Descriptive statistics, chi-square and t-tests were used to compare COVID-19 and non-COVID-19 patients.
Results: In all, 377 patients were admitted during this period. 100 COVID-19 and 100 non-COVID-19 patients were included. Table 1 demonstrates their baseline features. Both groups showed similar baseline risk of hospital-associated thrombosis, such as previous thromboembolism event, recognized “thrombophilia”, infarction or stroke within the past 4 weeks, and trauma or surgery within the past 4 weeks. Reduced mobility, however, was more frequent among non-COVID-19 than COVID-19 patients. Oxygen saturation was lower in COVID-19 (92% IQR 89% to 96%) than in non-COVID-19 patients (95% IQR 90% to 97%, P=0.03); accordingly, the need for invasive oxygen support was greater (44% vs. 33%, P=0.05) and longer (16.00 days IQR 8.50 to 22.50 vs. 12.50 days IQR 4.75 to 21.25, P=0.002) in COVID-19 than in non-COVID-19 patients. Coagulation markers such as activated partial thromboplastin time, prothrombin time, platelet count, and D-dimer levels (1,700.00ng/mL IQR 752.00 to 3,417.00 non-COVID-19; 1,426.50ng/mL IQR 744.25 to 3,461.00 COVID-19, P=0.17) were similar between groups. Although thromboprophylaxis was more frequently administered to COVID-19 (76%) than non-COVID-19 patients (42%, P<0.0001), thrombotic events were more recurrent in the former group (22% vs. 12%, P=0.06). Table 2 demonstrates the thrombotic manifestations’ characteristics.
| Non-COVID-19 (n=100) | COVID-19 (n=100) | P value | |
|---|---|---|---|
| Male, n (%) | 55 (55.00%) | 67 (67.00%) | 0.08 |
| Age in years, median (IQR) | 53.87 (43.94 to 68.91) | 57.36 (45.84 to 65.83) | 0.30 |
| Arterial hypertension, n (%) | 47 (47.00%) | 47 (47.00%) | 1.00 |
| Diabetes, n (%) | 30 (30.00%) | 35 (35.00%) | 0.45 |
| Obesity, n (%) | 14 (14.00%) | 23 (23.00%) | 0.10 |
| Active cancer, n (%) | 20 (20.00%) | 10 (10.00%) | 0.05 |
| Systemic autoimmune disease*, n (%) | 8 (8.00%) | 4 (4.00%) | 0.23 |
| Chronic infectious disease**, n (%) | 8 (8.00%) | 4 (4.00%) | 0.23 |
| End-stage CKD, n (%) | 6 (6.00%) | 8 (8.00%) | 0.58 |
Baseline demographic and clinical features of patients hospitalized due to SARS at the UNICAMP Clinical Hospital between March and May, 2020. Abbreviations: IQR interquartile range; CKD chronic kidney disease. * Gout, arthrosis, systemic lupus erythematosus, rheumatoid arthritis, systemic sclerosis, myasthenia gravis; ** Tuberculosis, Hansen’s disease, syphilis, gonorrhea, HIV, chronic hepatitis C and B.
| Non-COVID-19 (n=100) | COVID-19 (n=100) | P value | |
|---|---|---|---|
| Patients affected by thrombotic complications on ward, n (%) | 7 (7.00%) | 15 (15.00%) | 0.07 |
| Patients affected by thrombotic complications in ICU, n (%) | 5 (5.00%) | 7 (7.00%) | 0.55 |
| Deep vein thrombosis, n (%) | 4 (28.57%) | 6 (21.43%) | 0.51 |
| Pulmonary embolism, n (%) | 7 (50.00%) | 13 (46.43%) | 0.07 |
| Myocardial infarction, n (%) | 1 (7.14%) | 1 (3.57%) | 1.00 |
| Ischemic stroke, n (%) | 1 (7.14%) | 1 (3.57%) | 1.00 |
| Thrombosis in unusual venous or arterial sites*, n (%) | 1 (7.14%) | 7 (25.00%) | 0.03 |
| Duration of hospitalization in days, median (IQR) | 9.00 (4.75 to 17.00) | 16.00 (6.75 to 31.00) | <0.0001 |
| Death, n (%) | 19 (19.00%) | 24 (24.00%) | 0.39 |
Thrombotic complications during hospitalization due to SARS at the UNICAMP Clinical Hospital between March and May, 2020. Abbreviations: ICU intensive care unit; IQR interquartile range. * Upper limb (1 non-COVID-19; 2 COVID-19), neck (0 non-COVID-19; 2 COVID-19), renal artery (0 non-COVID-19; 1 COVID-19), iliac artery (0 non-COVID-19; 1 COVID-19), hepatic artery (0 non-COVID-19; 1 COVID-19).
Conclusions: In this study, we provide clinical evidence that the risk of thrombosis is more pronounced in COVID-19 than in other SARS. D-dimer analysis was not capable of differentiating the thrombotic risk between these conditions.
To cite this abstract in AMA style:
Coy Canguçu A, Aparecida Locachevic G, Silva Mariolano JC, de Oliveira Soares KH, Oliveira JD, de Oliveira Vaz C, Vieira Damiani G, Mazetto B, Annichino-Bizzacchi J, de Paula EV, Andrade Orsi F. COVID-19 Diagnosis and its Impact on Thrombotic Risk in a Cohort of Consecutive Patients Hospitalized due to Severe Acute Respiratory Syndrome [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/covid-19-diagnosis-and-its-impact-on-thrombotic-risk-in-a-cohort-of-consecutive-patients-hospitalized-due-to-severe-acute-respiratory-syndrome/. Accessed December 11, 2023.« Back to ISTH 2021 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/covid-19-diagnosis-and-its-impact-on-thrombotic-risk-in-a-cohort-of-consecutive-patients-hospitalized-due-to-severe-acute-respiratory-syndrome/