Post hospital discharge thrombosis in patients with COVID-19

Document Type

Conference Proceeding

Publication Date

10-1-2021

Publication Title

Research and Practice in Thrombosis and Haemostasis

Keywords

acute coronary syndrome, acute limb ischemia, adult, anticoagulation, artery thrombosis, cerebral sinus thrombosis, cerebrovascular accident, conference abstract, controlled study, COVID-19 testing, deep vein thrombosis, female, hospice, hospital discharge, hospital patient, hospitalization, human, ICD-10, intracardiac thrombosis, lung embolism, major clinical study, male, observational study, portal vein thrombosis, prophylaxis, randomized controlled trial, retrospective study

Abstract

Background : Coronavirus disease 2019 (COVID-19) is associated with a high incidence of thrombotic events during hospitalization, however, the need for postdischarge thromboprophylaxis remains unclear. Aims : To quantify the 90-day post hospital discharge rates of venous and arterial thromboembolism in COVID-19. Methods : A retrospective single institution observational study of adult patients hospitalized with COVID-19 confirmed by positive SARS-CoV-2 testing from 3/1/2020 to 8/31/2020. Patients were excluded if they: remained hospitalized at time of analysis, died during hospitalization or were discharged to hospice. For patients with multiple admissions related to COVID-19, the first admission was included. Thromboembolism was identified with ICD-10 codes up to 90 days of discharge: pulmonary embolism (PE: I26), deep vein thrombosis (DVT: I82), portal vein thrombosis (I81), intracranial venous thrombosis (I67),transient ischemia attack (TIA: G45), stroke (I63), acute coronary syndrome (ACS: I20, I21, I22, I24), intracardiac thrombosis (I23, I51.3), and acute limb ischemia (I74). Results : Of 1653 hospitalized patients, 26 (1.6%) developed post discharge venous thrombosis events (12 PE, 13 DVT and 1 portal vein thrombosis). Eleven (0.7%) post discharge arterial thrombosis events were observed(1 TIA and 10 ACS). The risk of VTE decreases with time (Mann-Kendall trend test P -value < 0.001) with median event time 15.5 days (IQR: 6-27). The risk of arterial thrombosis is constant with time (Mann-Kendall trend test P -value = 0.86) with median event time 54 days (IQR: 24-65). Conclusions : The rate thromboembolism is relatively low among COVID-19 patients after they leave the hospital. Results of ongoing randomized trials of the efficacy of post-discharge anticoagulation prophylaxis are eagerly awaited.

Volume

5

Issue

SUPPL 2

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