CC BY 4.0 · TH Open
DOI: 10.1055/a-1878-6806
Original Article

Thromboembolic complications in COVID-19 patients hospitalized in Italian ordinary wards: data from the multicentre observational START-COVID Reg

Thromboembolic complications in COVID-19 patients
Daniela Poli
1   Azienda Ospedaliero Universitaria Careggi, Firenze, Italy (Ringgold ID: RIN18561)
,
Emilia Antonucci
2   Fondazione Arianna Anticoagulazione, Bologna, Italy (Ringgold ID: RIN540487)
,
Walter Ageno
3   Medicine and Surgery, University of Insubria, Varese, Italy
,
Paolo Prandoni
2   Fondazione Arianna Anticoagulazione, Bologna, Italy (Ringgold ID: RIN540487)
,
Giovanni Barillari
4   ASU FC, Udine, Italy (Ringgold ID: RIN18026)
,
Giuseppina Bitti
5   Ospedale di Fermo, Fermo, Italy
,
Egidio Imbalzano
6   AOU Policlinico "G. Martino", Messina, Italy
,
Eugenio Bucherini
7   Angiologia e medicina Vascolare, AUSL della Romagna, Ravenna, Italy (Ringgold ID: RIN390233)
,
8   Sapienza University of Rome, Roma, Italy (Ringgold ID: RIN9311)
,
Vittorio Fregoni
9   Azienda Socio Sanitaria Territoriale della Valtellina e Alto Lario, Sondrio, Italy (Ringgold ID: RIN18685)
,
Silvia Galliazzo
10   Department of Medicine, Ospedlae San Valentino Montebelluna, Azienda ULSS n 2 Marca Trevigiana, Treviso, Italy (Ringgold ID: RIN18173)
,
Alberto Gandolfo
11   ASU GI, Trieste, Italy (Ringgold ID: RIN9247)
,
Elisa Grifoni
12   Opsedale di Empoli, Empoli, Italy
,
Franco Mastroianni
13   Ospedale Generale Regionale F Miulli, Acquaviva delle Fonti, Italy (Ringgold ID: RIN161123)
,
Serena Panarello
14   Ospedale Galliera, Genova, Italy
,
Raffaele Pesavento
15   Internal medicine, Padua University, Padova, Italy
,
Simona Pedrini
16   Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy (Ringgold ID: RIN188700)
,
Girolamo Sala
17   Ospedale di Busto Arsizio, Busto Arsizio, Italy (Ringgold ID: RIN18521)
,
Pasquale Pignatelli
18   Experimental Medicine, University of Rome La Sapienza, Rome, Italy
,
Paola Stefania Preti
19   Thrombosis and Haemostasis Centre, Department of Internal Medicine, Foundation IRCCS Polyclinic San Matteo, Pavia, Italy (Ringgold ID: RIN18631)
20   University of Pavia, Pavia, Italy (Ringgold ID: RIN19001)
,
Federico Simonetti
21   Azienda USL Toscana nord ovest Sede di Lucca, Lucca, Italy (Ringgold ID: RIN9251)
,
Piera Sivera
22   Ospedale Mauriziano Torino, Torino, Italy
,
Adriana Visoná
23   Angiology Unit, San Giacomo Hospital, Padova, Italy
,
Sabina Villalta
24   Department of Internal Medicine, Internal Medicine AULSS2 Marca Trevigiana;, Ospedale di Treviso, Treviso, Italy (Ringgold ID: RIN18703)
,
Rossella Marcucci
25   Medical and Surgical Critical Care Medicine, University of Florence, Florence, Italy
,
2   Fondazione Arianna Anticoagulazione, Bologna, Italy (Ringgold ID: RIN540487)
› Author Affiliations
Supported by: Italfarmaco

Background: COVID-19 infection causes acute respiratory insufficiency with severe interstitial pneumonia and extra-pulmonary complications; in particular, it may predispose to thromboembolic disease. The reported incidence of thromboembolic complications varies from 5% to 30% of cases. Aim. We conducted a multicentre, Italian, retrospective, observational study on COVID-19 patients admitted to ordinary wards, to describe clinical characteristic of patients at admission, bleeding and thrombotic events occurring during hospital stay. Results: 1135 patients hospitalized were included in the START-COVID-19 Register, 1091 patients hospitalized in ordinary wards were included in the study, 653 males (59.9%), median age 71 years (IQR 59-82 years). During the observation, 2 (0.2%) patients had acute coronary syndrome episodes, 1 patient (0.1%) had an ischemic stroke; no other arterial thrombotic events were recorded. Fifty-nine patients had symptomatic VTE (5.4%) events, including 18 (30.5%) deep vein thrombosis (DVT), 39 (66.1%) pulmonary embolism (PE), and 2 (3.4%) DVT + PE. Among patients with DVT, 8 (44.4%) were isolated distal DVT, and 2 cases were jugular thrombosis. Among patients with PE, 7 (17.9%) events were limited to sub-segmental arteries. No fatal PE were recorded. Major bleedings occurred in 9 (1.2%) patients, and clinically relevant non-major bleeding in 9 (1.2%) patients. All bleedings occurred among patients receiving thromboprophylaxis, more frequently when treated with sub-therapeutic or therapeutic dosages. Conclusion: Our findings confirm that patients admitted to ordinary wards for COVID-19 infection are at high risk for thromboembolic events. VTE recorded among these patients are mainly isolated PE, suggesting a peculiar characteristic of VTE in these patients.



Publication History

Received: 11 January 2022

Accepted after revision: 21 April 2022

Accepted Manuscript online:
19 June 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

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