Thromboembolic Events Among Patients Hospitalized With COVID-19 Pneumonia

Older patients with COVID-19 pneumonia with a history of diabetes, ischemic cardiovascular disease (CVD), and chronic liver disease (CLD) were at increased risk for thromboembolic events. These findings were published in the Annals of Medicine and Surgery.

This retrospective, observational cohort study evaluated the risk for thromboembolic events among patients (N=46) with COVID-19 pneumonia admitted to the Mogadishu Somali Turkish Training and Research Hospital in January and February of 2020. Thromboembolic events included pulmonary embolism and deep vein thrombosis (DVT), diagnosed via whole-leg ultrasonagraphy and CT angiography of the chest. The researchers assessed outcomes among patients with reported thromboembolic events vs those with reported nonthromboembolic events (controls).

The study population comprised 63% men, and the majority of patients (34.8%) were aged between 25 and 39 years.

Among patients included in the study, thromboembolic events occurred in 41.3%. The researchers found that thromboembolic events were more likely to occur among patients older than 65 years, as well as those with ischemic CVD (P =.003), CLD (P =.03) and diabetes (P =.025). The most common events included cerebrovascular accident in 15.22%, pulmonary embolism in 13.04%, acute myocardial infarction in 8.70%, and DVT in 4.35%.

Compared with patients in the control group, the frequency of headache (21.7% vs 13%), chest pain (28.3% vs 4.3%), altered consciousness (17.4% vs 4.3%), and hemiplegia (15.2% vs 2.2%) was increased among those with reported thromboembolic events (all P ≤.043). 

Results of CT angiography of the chest showed that patients with reported thromboembolic events vs those in the control group had increased rates of linear opacities (13% vs 2.2%), pleural effusion (11% vs 4.3%), lymphadenopathy (8.7% vs 6.5%), and cavitation (8.7% vs 2.2%). Of note, only the increased rate of linear opacities among patients with reported thromboembolic events was statistically significant (P =.015).

Compared with those in the control group, more patients with reported thromboembolic events received anticoagulants (41.3% vs 15.2%) and required invasive mechanical ventilation (19.6% vs 6.5%; P =0.008). In addition, mortality occurred among 6 patients with reported thromboembolic events vs 1 in the control group.

This study was limited by its small sample size.

According to the researchers, “further studies are needed to uncover systemic… risk factors” associated with the occurrence of thromboembolic events among patients with COVID-19 pneumonia.

Reference

Mohamud MFY, Mukhtar MS. Epidemiological characteristics, clinical relevance, and risk factors of thromboembolic complications among patients with COVID-19 pneumonia at a teaching hospital: retrospective observational study. Ann Med Surg. 2022;77:103660. doi:10.1016/j.amsu.2022.103660