Abstract Number: PB/CO13
Meeting: ISTH 2020 Congress
Theme: Venous Thromboembolism and Cardioembolism » VTE Epidemiology
Background: Reports from areas significantly affected by the COVID-19 pandemic have observed high rates of thromboembolic events ranging from (2-69%) but studies have lacked an adequate control population, making interpretations of the results difficult.
Aims: Determine thrombotic outcomes (venous and arterial) in hospitalized patients with COVID-19 testing.
Methods: Adult hospitalized patients with COVID-19 testing by PCR assay were identified through electronic health records across the Mayo Clinic Enterprise (academic and regional hospitals representing different regions of the United States) through 5/8/2020. Thrombotic outcomes (venous and arterial) were identified from the hospital problem list.
Results: 3790 patients with admission and COVID-19 testing were identified across 19 different hospitals, among which 102 tested positive. Median age was lower in the COVID positive patients (62 vs 67, p=0.02; Table 1). Median length of hospitalization was longer in COVID positive patients (9 vs 4 days, p< 0.001) and more required ICU care (57.1% vs 26.7%, p< 0.001). Comorbidities such as atrial fibrillation/flutter, heart failure, chronic kidney disease, and malignancy were all observed less frequently with COVID positive admissions (Table 1). Any VTE was identified in 2.9% of COVID positive and 4.6% of COVID negative patients (p=0.41; Table 2). The frequency of venous and arterial events was not significantly different between the groups. The unadjusted OR for COVID positive patients for any VTE was 0.63 (95% CI 0.19-2.02). In a multivariate logistic regression model evaluating death within 30 days of hospital discharge, neither COVID positivity (aOR 1.02, 95% CI 0.49-2.11) nor any thromboembolism (aOR 0.90, 95% CI 0.60-1.32) was associated with death.
Conclusions: Early experience with COVID-19 patients across multiple academic and regional hospitals representing different regions of the United States demonstrates a lower than previously reported incidence of thrombotic events in a high-risk cohort, which is not significantly higher than COVID negative hospitalized patients.
| COVID positive N=102 | COVID negative N=3688 | P value | |
| Age, Median (IQR) | 62(52-74) | 67 (54-78) | 0.03* |
| BMI, median (IQR) | 28.9 (24.7-35.65) | 27.2 (23.4-32.5) | 0.005 |
| LOS (days), median (IQR) | 8.5 (4.0-14.25) | 4 (3-7) | <0.001* |
| ICU care, % (n) | 57% (58) | 27% (987) | <0.001 |
| Hospital Day of COVID Test, median (IQR) | 1 (0-4) | 0 (0-1) | <0.001* |
| History of VTE, % (n) | 2.9% (3) | 3.4% (127) | 0.78 |
| Atrial fibrillation/flutter, % (n) | 13% (13) | 23 % (848) | 0.02 |
| Heart failure, % (n) | 14% (14) | 26% (968) | 0.004 |
| Malignancy, % (n) | 13% (13) | 27% (983) | 0.002 |
[Characteristics and comorbidities in COVID positive and negative hospitalized patients]
| COVID positive N=102 | COVID negative N=3688 | P value | |
| Any VTE event, % (n) | 2.9% (3) | 4.6% (168) | 0.43 |
| PE, % (n) | 1.0% (1) | 2.5% (91) | 0.34 |
| LE-DVT, % (n) | 0 | 1.7% (62) | 0.19 |
| UE-DVT, % (n) | 2.9% (3) | 0.6% (22) | 0.004 |
| Atypical DVT, % (n) | 0 | 0.5% (19) | 0.47 |
| Any VTE (ICU admissions), % (n) | 3.5% (2) | 7.2% (71) | 0.28 |
| Any thromboembolism, % (n) | 5.9% (6) | 10% (375) | 0.16 |
| Any bleeding, % (n) | 2.9% (3) | 7.0% (259) | 0.11 |
| Death (30 day) , % (n) | 8.9% (9) | 7.2% (267) | 0.54 |
[Thromboembolic, bleeding, and death in COVID positive versus negative hospitalized patients]
To cite this abstract in AMA style:
Houghton D, Chaudhary R, Padrnos L, Wysokinska E, Pruthi R, Misra S, Wysokinski W, McBane R. Macrovascular Thrombotic Events in a Mayo Clinic Enterprise-wide Sample of Hospitalized COVID-19 Positive Compared to Negative Patients [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/macrovascular-thrombotic-events-in-a-mayo-clinic-enterprise-wide-sample-of-hospitalized-covid-19-positive-compared-to-negative-patients/. Accessed November 29, 2023.« Back to ISTH 2020 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/macrovascular-thrombotic-events-in-a-mayo-clinic-enterprise-wide-sample-of-hospitalized-covid-19-positive-compared-to-negative-patients/