Clinical characteristics and risk factors for symptomatic venous thromboembolism in hospitalized COVID-19 patients: A multicenter retrospective study


Li, Jun-Ying, Wang, Hong-Fei, Yin, Ping, Li, Di, Wang, Di-Le, Peng, Peng, Wang, Wei-Hua, Wang, Lan, Yuan, Xiao-Wei, Xie, Jin-Yuan et al (show 13 more authors) (2021) Clinical characteristics and risk factors for symptomatic venous thromboembolism in hospitalized COVID-19 patients: A multicenter retrospective study. JOURNAL OF THROMBOSIS AND HAEMOSTASIS, 19 (4). pp. 1038-1048.

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Abstract

<h4>Background</h4>High incidence of asymptomatic venous thromboembolism (VTE) has been observed in severe COVID-19 patients, but the characteristics of symptomatic VTE in general COVID-19 patients have not been described.<h4>Objectives</h4>To comprehensively explore the prevalence and reliable risk prediction for VTE in COVID-19 patients.<h4>Methods/results</h4>This retrospective study enrolled all COVID-19 patients with a subsequent VTE in 16 centers in China from January 1 to March 31, 2020. A total of 2779 patients were confirmed with COVID-19. In comparison to 23,434 non-COVID-19 medical inpatients, the odds ratios (ORs) for developing symptomatic VTE in severe and non-severe hospitalized COVID-19 patients were 5.94 (95% confidence interval [CI] 3.91-10.09) and 2.79 (95% CI 1.43-5.60), respectively. When 104 VTE cases and 208 non-VTE cases were compared, pulmonary embolism cases had a higher rate for in-hospital death (OR 6.74, 95% CI 2.18-20.81). VTE developed at a median of 21 days (interquartile range 13.25-31) since onset. Independent factors for VTE were advancing age, cancer, longer interval from symptom onset to admission, lower fibrinogen and higher D-dimer on admission, and D-dimer increment (DI) ≥1.5-fold; of these, DI ≥1.5-fold had the most significant association (OR 14.18, 95% CI 6.25-32.18, p = 2.23 × 10<sup>-10</sup> ). A novel model consisting of three simple coagulation variables (fibrinogen and D-dimer levels on admission, and DI ≥1.5-fold) showed good prediction for symptomatic VTE (area under the curve 0.865, 95% CI 0.822-0.907, sensitivity 0.930, specificity 0.710).<h4>Conclusions</h4>There is an excess risk of VTE in hospitalized COVID-19 patients. This novel model can aid early identification of patients who are at high risk for VTE.

Item Type: Article
Uncontrolled Keywords: COVID-19, D-dimer increment, SARS-CoV-2, thrombosis, venous thromboembolism
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Depositing User: Symplectic Admin
Date Deposited: 18 Mar 2021 08:16
Last Modified: 04 Jul 2023 15:11
DOI: 10.1111/jth.15261
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3117644
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