Incidence of symptomatic venous thromboembolism following hospitalization for coronavirus disease 2019: Prospective results from a multi-center study

Thrombosis and pulmonary embolism appear to be major causes of mortality in hospitalized coronavirus disease 2019 (COVID-19) patients. However, few studies have focused on the incidence of venous thromboembolism (VTE) after hospitalization for COVID-19. In this multi-center study, we followed 1529 C...

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Published in:	Thrombosis research Vol. 198; pp. 135 - 138
Main Authors:	Rashidi, Farid, Barco, Stefano, Kamangar, Farin, Heresi, Gustavo A., Emadi, Ashkan, Kaymaz, Cihangir, Jansa, Pavel, Reis, Abilio, Rashidi, Arash, Taghizadieh, Ali, Rezaeifar, Parisa, Moghimi, Minoosh, Ghodrati, Samad, Mozafari, Abolfazl, Foumani, Ali Alavi, Tahamtan, Ouria, Rafiee, Effat, Abbaspour, Zahra, Khodadadi, Kasra, Alamdari, Golsa, Boodaghi, Yasman, Rezaei, Maryam, Muhammadi, Muhammad Javad, Abbasi, Meysam, Movaseghi, Fatemeh, Koohi, Ata, Shakourzad, Leila, Ebrahimi, Fatemeh, Radvar, Sarvin, Amoozadeh, Maryam, Fereidooni, Fatemeh, Naseari, Hanieh, Movalled, Kobra, Ghorbani, Ozra, Ansarin, Khalil
Format:	Journal Article
Language:	English
Published:	United States Elsevier Ltd 01-02-2021
Subjects:	Adult Aged Aged, 80 and over Cohort study COVID-19 COVID-19 - diagnosis COVID-19 - epidemiology COVID-19 - mortality COVID-19 - therapy Female Full Length Hospitalization Humans Incidence Iran - epidemiology Male Middle Aged Patient Discharge Prospective Studies Pulmonary Embolism - diagnosis Pulmonary Embolism - epidemiology Pulmonary Embolism - mortality Risk Factors Thromboprophylaxis Time Factors Venous thromboembolism Venous Thromboembolism - diagnosis Venous Thromboembolism - epidemiology Venous Thromboembolism - mortality Venous Thrombosis - diagnosis Venous Thrombosis - epidemiology Venous Thrombosis - mortality Iran COVID-19 Thromboprophylaxis Hospitalization Cohort study Venous thromboembolism
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Summary:	Thrombosis and pulmonary embolism appear to be major causes of mortality in hospitalized coronavirus disease 2019 (COVID-19) patients. However, few studies have focused on the incidence of venous thromboembolism (VTE) after hospitalization for COVID-19. In this multi-center study, we followed 1529 COVID-19 patients for at least 45 days after hospital discharge, who underwent routine telephone follow-up. In case of signs or symptoms of pulmonary embolism (PE) or deep vein thrombosis (DVT), they were invited for an in-hospital visit with a pulmonologist. The primary outcome was symptomatic VTE within 45 days of hospital discharge. Of 1529 COVID-19 patients discharged from hospital, a total of 228 (14.9%) reported potential signs or symptoms of PE or DVT and were seen for an in-hospital visit. Of these, 13 and 12 received Doppler ultrasounds or pulmonary CT angiography, respectively, of whom only one patient was diagnosed with symptomatic PE. Of 51 (3.3%) patients who died after discharge, two deaths were attributed to VTE corresponding to a 45-day cumulative rate of symptomatic VTE of 0.2% (95%CI 0.1%–0.6%; n = 3). There was no evidence of acute respiratory distress syndrome (ARDS) in these patients. Other deaths after hospital discharge included myocardial infarction (n = 13), heart failure (n = 9), and stroke (n = 9). We did not observe a high rate of symptomatic VTE in COVID-19 patients after hospital discharge. Routine extended thromboprophylaxis after hospitalization for COVID-19 may not have a net clinical benefit. Randomized trials may be warranted. •In a large multi-center study, the incidence of venous thromboembolism in COVID-19 patients followed for 45 days after hospitalization was relatively low.•Routine extended thromboprophylaxis in COVID-19 patients who have been discharged from the hospital may not have a net clinical benefit.•Older age, history of recent cancer, and history of recent diabetes were associated with higher risk of mortality after hospital discharge
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0049-3848 1879-2472 1879-2472
DOI:	10.1016/j.thromres.2020.12.001