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