ABSTRACT
Background : Since the beginning of the SARS-CoV 2 pandemic, there have been many reports of increased incidence of VTE (venous thromboembolism) and arterial events as a complication, which were the basis for the hypothesis that patients should receive higher doses of thromboprophylaxis (TP) or full anticoagulation. Aims : To determine the incidence of thrombotic events (TE) in patients hospitalized for moderate or severe SARS-CoV2 disease (Covid-19). Methods : Retrospective single center cohort study with adult patients with a positive rt-PCR for SARS-CoV2 , included as from the date of hospital admission due to Covid-19 and followed for 90 days or until death. Results : A total of 1621 patients were included. The mean age was 68.7 years (SD 21.1) and 57% (913) were female, of which 6.5% (59) were pregnant. Overall mortality was 21.6% (348). The overall incidence of symptomatic thrombotics events within 90 days was 1.72% (28/1621, 95%CI 1.19-2.49%), whereas the incidence of pulmonary embolism (PE) was 0.98% (15, 95%CI 0.60-0.16%), deep venous thrombosis (DVT) 0.74% (11, 95%CI 0.42-0.12%), ischemic stroke 0.24% (4, 95%CI 0.09-0.65%) and ischemic arterial events 0.06% (1, 95%CI 0.008-0.43%). No acute coronary syndrome events were recorded. Median hospital stay length percentage under adequate TP was 78%. The median time since positive rt-PCR for the thrombotic event to develop was 22 days (IQR 25th-75th 19-43 days). Median hospital stay length percentage under adequate thromboprophylaxis was 78% (IQR 25th-75th 50-89%). Conclusions : Unlike previous reports, the incidence of thrombotic events was low among our patients with moderate or severe Covid-19.
ABSTRACT
A multicenter registry that included adults hospitalized for COVID-19 was carried out in various provinces of Argentina, from March to October 2020. The objectives were to describe the epidemiological characteristics, clinical manifestations, treatments, complications and risk factors, need for admission to critical care units and mortality. The registry included information on 4776 patients in 37 health centers in Argentina. Of them, 70.2% came from the city of Buenos Aires and from Buenos Aires Province;52.3% were men. The mean age was 56 years (SD 20.3). Of them, 13.1% stated that they were health personnel. The median time of symptoms at the time of hospitalization was 3 days (CI 1-6). The most frequent comorbidities were hypertension in 32.4% and diabetes mellitus in 15.8%. The most frequent symptoms were: cough 58%, odynophagia 23.3%, myalgia 20.5% and fever / low-grade fever 19.9%. The hospital stay had a median of 8 days (CI 4-15). A 14.8% of the patients required critical care, while 3.2% who also required it, were not transferred to a closed unit due to adequacy of the therapeutic effort. The most frequent complications in critical care were: cardiovascular events (54.1%), septic shock (33.3%), renal failure (9.7%) and pneumonia associated with mechanical ventilation (12.5%). Overall mortality was 12.3%. Old age, dementia and COPD behaved as independent predictors of mortality (p < 0.001, 0.007 and 0.002 respectively) in the multivariate analysis.