Venous thromboembolism in patients hospitalized with COVID-19: Results from the Brazilian COVID-19 registry

ABSTRACT

Background: COVID-19 patients are at increased risk of venous thromboembolism (VTE), and this complication leads to a worse prognosis. However, to diagnose VTE on COVID-19 patients is a challenge to physicians, as the symptoms of pulmonary embolism can often be mistaken for the overlapped viral pneumonia. Herein, there is still little information on VTE incidence and associated risk factors specifically for this population. Aims: To assess the incidence and associated risk factors for VTE in hospitalized COVID-19 patients in Brazilian hospitals. Methods: Retrospective multicenter cohort in 15 Brazilian hospitals. Consecutive adult patients (≥ 18 years-old) with laboratoryconfirmed COVID-19 between March and September 2020 were included. Study data were collected from medical records using Research Electronic Data Capture (REDCap) tools. The study was approved by the National Research Ethics Commission waiving off the application of informed consent. Results: Of 4,021 patients included, 234 (5.8%) had VTE. When comparing VTE and non-VTE groups (Tables 1 and 2), there was no statistical difference in terms of sex and age between groups. The median age was 63 years-old (IQR 51-72 years-old) in VTE group. The most common comorbidities for both groups were hypertension and diabetes. Obesity, chronic pulmonary obstructive disease, previous VTE and recent surgery were more frequent in VTE group. D-dimer, C-reactive protein, lactate dehydrogenase levels and lymphocyte count were higher in the VTE group. Admission to intensive care units (37.6% vs 69.7%;P < 0,001) and in-hospital mortality (19.0% vs 28.3%;P < 0,01) were significantly higher in those who had VTE. Conclusions: Overall, 5.8% of COVID-19 hospitalized patients had VTE. Elevated laboratory values were associated with increased risk of this condition. VTE was associated with higher rates of intensive care admission and in-hospital mortality.