To Study the Clinical Profile of Thromboembolic Events in Covid 19 Patients.

ABSTRACT

The sars -cov 2 causing covid 19 disease. B/l pneumonia, systemic inflammation, coagulation activation, ards , multiorgan failure are key features of covid 19. Patients need icu admission. Proinflammatory cytokines, tnf, il 6, 8, 1 beta, causes cytokine storm in covid 19 disease. MATERIAL: In this single-center, retrospective, cross sectional study, the clinical and laboratory characteristics of 154 patients with severe covid-19 were collected. 38 Patients with severe covid -19 had incidence of thromboembolism with its symptoms, and 116 patients (ie, the controls) did not have incidence of thromboembolism. A severe case was defined as including at least one of the following criteria (1) respiratory rate >30/ min. (2) Oxygen saturation ≤90%. (3) Pao2 /fio2 ≤300mm hg. (4) Patients, either with shock or respiratory failure, requiring mechanical ventilation, or combined with other organ failure, requiring admission to intensive care unit (icu). Also pe cases were those patients with high clinical suspicion [tachycardia >100 bpm, systolic arterial tension <100 mmhg or signs of right ventricular pressure overload]. Pe severity was assessed using the simplified pulmonary embolism severity index (s -pesi). OBSERVATION Of 154 patients with severe covid-19, 38 (24.67%) Had incidence of thromboembolism. Compared with patients with severe covid-19 without incidence of thromboembolism, patients with incidence of thromboembolism were older, susceptible to receiving mechanical ventilation and admission to icu, and had higher mortality. In addition, patients with severe covid-19 with thromboembolism had higher levels of leukocyte count, neutrophil count, high-sensitivity c reaction protein, procalcitonin, ferritin, interleukin (il) 2 receptor, il-6, il-8, tumor necrosis factor α, D-dimer, fibrinogen, lactic dehydrogenase and n-terminal probrain natriuretic peptide. Among patients with severe covid-19 with incidence of thromboembolism, more non-survivors were men (30 (75%) vs women (25%)). Non-survivors had severe inflammatory response, and cardiac, hepatic, renal and coagulation impairment. Finally, the kaplan-meier survival curve showed a trend towards poorer survival in patients with severe covid-19 with incidence of thromboembolism than patients without incidence of thromboembolism. The hr was 2.24 [95% Ci 1.17-4.29], P = 0.015). After adjustment for age, sex, hypertension, cardiovascular disease and cerebrovascular disease by cox regression. The median survival durations from hospital admission in patients with severe covid-19 with and without incidence of thromboembolism were 8 days and 15 days, respectively. CONCLUSION: The mortality rate in patients with severe covid-19 with incidence of thromboembolism is high. Incidence of thromboembolism may lead to an increase in the risk of death.