PB0069 - Risk Factors for Venous Thromboembolism in patients hospitalized with COVID-19

Background: Venous thromboembolism (VTE) is a frequent complication of COVID-19. The identification of VTE risk factors (RF) may help physicians to select the best anticoagulation schedule in clinical practice.

Aims: To evaluate RF associated with VTE in hospitalized COVID-19 patients.

Methods: We retrospectively analyzed (Jan/20-Feb/21) all cases of COVID-19 submitted to a compression ultrasound (CUS) and/or CT pulmonary angiogram (CTPA) to investigate deep venous thrombosis (DVT) or pulmonary embolism (PE), respectively, based on clinical suspicion. Potential RF for VTE including age, gender, obesity, cancer, hemodialysis support, mechanical ventilation and extent of viral pulmonary infiltrate on CT-SCAN (mild < 25%, moderate 25-50% or severe>50%) were evaluated. D-Dimer (DD) and C reactive protein (t-CRP) levels were recorded at hospital admission and on the day (±24h) of each imaging exam performed, and were categorized into tertiles to determine VTE risk.

Results: Of 823 COVID-19 hospitalizations, we identified 201 patients (median age 67 years [20-103], 69% male) submitted to a 245 imaging studies (83 CTPA, 162 CUS). In the overall cohort, 70 (35%) patients had VTE diagnosis according to 83 positive exams (55 CUS and 28 CTPA). Traditional VTE RF such as age (p=0.240), gender (p=0.053), obesity (p=0.874) and cancer (p=0.770) were not found to be associated with VTE events. We identified an association between VTE and mechanical ventilation (OR 2.05,95%CI 1.43–2.95), hemodialysis (OR 1.76,95%CI 1.21–2.56), severity of pulmonary infiltrate >50% (OR 1.52,95%CI 1.03–2.26), higher DD levels on admission (1728 vs. 919ng/mL; p=0.009) and on the day of imaging studies (7013 vs 1378ng/mL; p< 0.001). There was no association between VTE and t-CRP on admission (p=0.288) or prior to VTE screening (p=0.564) (Table 1).

Conclusion(s): In patients with COVID-19, the severity of disease characterized by the need for mechanical ventilation, hemodialysis support, extensive pulmonary infiltrate, and higher levels of DD represented important RF for VTE.