Thromboembolic complications during and after hospitalization for COVID-19: Incidence, risk factors and thromboprophylaxis

Tholin, Birgitte; Fiskvik, Hilde; Tveita, Anders; Tsykonova, Galina; Opperud, Helene; Busterud, Kari; Mpinganzima, Clarisse; Garabet, Lamya; Ahmed, Jamal; Stavem, Knut

doi:10.1016/j.tru.2021.100096

Cited by 4 publications

(1 citation statement)

References 42 publications

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“…Thromboembolic episodes are reported to have increased due to complications of COVID infection and, rarely, vaccination (the AstraZeneca vaccine was implicated) (18). Up to 7% of hospitalized patients were reported to experience thromboembolic complications within 90 days of infection, though apparently no deaths in 61 cases were attributed primarily to thrombotic complications (19).…”

Section: Discussionmentioning

confidence: 99%

Characteristics of Coronial Autopsy Cases in the London Area of the United Kingdom, Pre and Post COVID-19 Lockdown

Bates¹

2023

Academic Forensic Pathology

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Introduction: In order to reduce transmission of COVID-19, in March 2020 the UK national and devolved governments imposed restrictions including spatial distancing, stay-at-home orders, and travel restrictions. The aim of this study is to compare the characteristics of cases referred to the Coronial system for autopsy in the months before and during the lockdown period. Methods: In all, 580 autopsy cases, performed in the London area between January and June 2020 were included in the study. Results: In the postlockdown period, there was an increase in the proportion of black individuals referred for autopsy, which just attained statistical significance ( p = 0.047). The proportion of decomposed bodies submitted for examination was significantly increased ( p = 0.011). The study did not show a significant increase in the proportion of out-of-hospital (community) deaths, traumatic deaths, or deaths due to alcohol or drug abuse or overdose. Conclusion: The study shows no evidence that COVID-19 preventative measures led to a change in the causes of death referred to the Coroner, except, of course, for COVID-related deaths. The proportion of black people among subjects for autopsy increased, probably because of a relatively higher incidence of COVID deaths among this group. Decomposed subjects were more common, probably due to social isolation.

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Section: Discussionmentioning

confidence: 99%

Characteristics of Coronial Autopsy Cases in the London Area of the United Kingdom, Pre and Post COVID-19 Lockdown

Bates¹

2023

Academic Forensic Pathology

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A systematic review of thromboembolic complications and outcomes in hospitalised COVID-19 patients

Othman,

Zaki,

Isa

et al. 2024

BMC Infect Dis

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Thromboembolic (TE) complications [myocardial infarction (MI), stroke, deep vein thrombosis (DVT), and pulmonary embolism (PE)] are common causes of mortality in hospitalised COVID-19 patients. Therefore, this review was undertaken to explore the incidence of TE complications and mortality associated with TE complications in hospitalised COVID-19 patients from different studies. A literature search was performed using ScienceDirect and PubMed databases using the MeSH term search strategy of “COVID-19”, “thromboembolic complication”, “venous thromboembolism”, “arterial thromboembolism”, “deep vein thrombosis”, “pulmonary embolism”, “myocardial infarction”, “stroke”, and “mortality”. There were 33 studies included in this review. Studies have revealed that COVID-19 patients tend to develop venous thromboembolism (PE:1.0-40.0% and DVT:0.4-84%) compared to arterial thromboembolism (stroke:0.5-15.2% and MI:0.8-8.7%). Lastly, the all-cause mortality of COVID-19 patients ranged from 4.8 to 63%, whereas the incidence of mortality associated with TE complications was between 5% and 48%. A wide range of incidences of TE complications and mortality associated with TE complications can be seen among hospitalized COVID-19 patients. Therefore, every patient should be assessed for the risk of thromboembolic complications and provided with an appropriate thromboprophylaxis management plan tailored to their individual needs.

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A systematic review on post-discharge venous thromboembolism prophylaxis in patients with COVID-19

Amani-Beni,

Kermani-Alghoraishi,

Darouei

et al. 2023

Egypt Heart J

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Background Coronavirus disease of 2019 (COVID-19) is associated with venous thromboembolism (VTE), not only during hospitalization but also after discharge, raising concerns about anticoagulant (AC) use for post-discharge COVID-19 patients. We aimed to systematically review the current literature on the possible benefits or risks regarding extended thromboprophylaxis. Main body We searched related databases from December 1, 2019, to October 6, 2022, including studies on the necessity, duration, and selection of the ideal AC regarding extended thromboprophylaxis for post-discharge COVID-19 patients. The screening of the selected databases led to 18 studies and 19 reviews and guidelines. Studies included 52,927 hospitalized COVID-19 patients, with 19.25% receiving extended thromboprophylaxis. VTE events ranging from 0 to 8.19% (median of 0.7%) occurred in a median follow-up of 49.5 days. All included studies and guidelines, except four studies, recommended post-discharge prophylaxis after an individual risk assessment indicating high thrombotic and low bleeding risk. Studies used risk assessment models (RAMs), clinical evaluation, and laboratory data to identify COVID-19 patients with a high risk of VTE. IMPROVE-DD was the most recommended RAM. Direct oral anticoagulants (DOACs) and low molecular weight heparins (LMWHs) were the most used AC classes. Conclusions Post-discharge prophylaxis for COVID-19 patients is recommended after an individual assessment. The IMPROVE-DD model can help predict VTE risk. After distinguishing patients who need post-discharge AC therapy, DOACs for 30–35 days and LMWHs for 40–45 days can be the drug of choice. Further studies, particularly the results of the ongoing randomized controlled trials (RCTs), are required. Also, to properly handle such patients, every physician should consider lifestyle modification in addition to pharmacological treatment for post-discharge VTE prophylaxis.

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Thromboembolic complications during and after hospitalization for COVID-19: Incidence, risk factors and thromboprophylaxis

Cited by 4 publications

References 42 publications

Characteristics of Coronial Autopsy Cases in the London Area of the United Kingdom, Pre and Post COVID-19 Lockdown

Characteristics of Coronial Autopsy Cases in the London Area of the United Kingdom, Pre and Post COVID-19 Lockdown

A systematic review of thromboembolic complications and outcomes in hospitalised COVID-19 patients

A systematic review on post-discharge venous thromboembolism prophylaxis in patients with COVID-19

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