Mortality and bleeding complications of CoVID-19 critically ill patients with venous thromboembolism

Background: Venous thromboembolism (VTE) disease in COVID-19 patients is a remarkable issue, especially its relationship with bleeding events and mortality. The objective of this study was to describe the outcomes of critically ill patients with COVID-19, hospitalized in the Intensive Care Unit (ICU...

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Detalles Bibliográficos
Autores: Gil-Sala, Daniel|||0000-0003-4885-5836, Riera, Clàudia, García Reyes, Marvin Ernesto|||0000-0001-8813-9987, Rodríguez, Manuela, Marrero, Carlos, Martínez, Lucia|||0000-0002-2941-0922, Gil Olaria, Miquel|||0000-0001-9628-6071, Ruiz-Rodriguez, Juan Carlos|||0000-0001-7392-8617, Ferrer, Ricard|||0000-0002-4859-4747, Nadal Clanchet, Miriam de|||0000-0002-4559-2463, Suito Alcántara, Milagros A., Llagostera Pujol, Secundino|||0000-0003-3895-5761, Bellmunt Montoya, Sergi|||0000-0002-2851-720X
Tipo de recurso: artículo
Fecha de publicación:2022
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:dnet:uabarcelona_::b4a97f0ab5fe90c744f9ebc48a94f03c
Acceso en línea:https://ddd.uab.cat/record/328419
https://dx.doi.org/urn:doi:10.23736/S0392-9590.21.04704-0
Access Level:acceso abierto
Palabra clave:SARS-CoV-2 infection
COVID19
Venous thromboembolism
Deep venous thrombosis
Mortality
Bleeding
Descripción
Sumario:Background: Venous thromboembolism (VTE) disease in COVID-19 patients is a remarkable issue, especially its relationship with bleeding events and mortality. The objective of this study was to describe the outcomes of critically ill patients with COVID-19, hospitalized in the Intensive Care Unit (ICU), in relationship with VTE during their stay. Methods: This is a prospective cohort study of critically ill COVID-19 patients in two hospitals that underwent a venous ultrasound at the beginning of follow-up of both lower limbs in April 2020. In case of clinical suspicion of new VTE during the 30-day follow-up, additional ultrasound or thoracic CT were performed. Global VTE frequency, major bleeding events and survival were collected, and their predictors were studied. Results: We included 230 patients. After 30 days of follow-up, there were 95 VTE events in 86 patients (37.4%). Thirteen patients (5.7%) developed major bleeding complications and 42 patients (18.3%) died. None of the comorbidities or previous treatments were related with bleeding events. D-Dimer at admission was significantly related with VTE development and mortality. Independent predictors of mortality in the regression model were older age (>66 years), D-Dimer at admission (>1.500 ng/mL) and low lymphocyte count (<0.45×10/L) with an AUC in the ROC curve of 0.81 (95% CI: 0.73-0.89). Patients presenting these three conditions presented a mortality of 100% in the predictive model. Conclusions: VTE frequency in ICU COVID-19 patients is high and risk of major bleeding is low. Comorbidities and laboratory parameters of admission in these patients can be a useful tool to predict mortality.

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