Thromboembolic events in COVID-19 patients : A Tunisian case series study

Abstract

Coronavirus disease 2019 (COVID‐19) can lead to systemic coagulation activation and thrombotic complications(TC), which may lead to fatal outcomes if not diagnosed and managed appropriately.

We aimed to report the incidence and characteristics of venous and arterial thrombotic complications(TC) in hospitalized patients with COVID-19 and to investigate the predictive factors of their occurrence.

A retrospective study including 200 patients with COVID-19 confirmed by a reverse transcription polymerase chain reaction test, admitted between March 2020 and January 2021 in the pulmonary departement B at Abderrahman Mami Hospital was conducted. We compared the characteristics of 2 groups: patients with TC and patients without TC.

The median age was 64,9±13,5 [22– 98] years and 65% were men. A total of 26(13%) patients required intensive care. The most comon comorbidities were hypertension(46%),diabetes(40%) and obesity(32%).The incidence of TC was 22%(44/200).Pulmonary embolism was confirmed in 21 patients, and deep venous thrombosis was confirmed in 9 patients. Acute limb ischemia, acute coronary syndrome and ischemic stroke were observed in 4.5%,1.5% and 1% respectively. Thrombotic events occured within 4,7±2,1 days of hospital admission. Besides ICU stay(p=0,02),other risk factors associated with TC in univariable regression analyses were higher neutrophil‐to‐lymphocyte ratio (p=0,04),and a higher D‐dimer level (p=0,002).TC appeared to be associated with death (p<0.001).

Thrombotic complications in Covid 19 are associated with poor prognosis. The increase of D-dimer level and the higher neutrophil‐to‐lymphocyte ratio seems to be good index for identifying high-risk groups of TC.