Incidence, risk factors, clinical characteristics and outcomes of deep venous thrombosis in patients with COVID-19 attending the Emergency Department: results of the UMC-19-S8

• Published in: European journal of emergency medicine Vol. 28; no. 3; p. 218
• Main Authors: Jiménez, Sònia, Miró, Òscar, Llorens, Pere, Martín-Sánchez, Francisco J, Burillo-Putze, Guillermo, Piñera, Pascual, Martín, Alfonso, Alquézar, Aitor, García-Lamberechts, Eric J, Jacob, Javier, Grima, María L L, Millán, Javier, Molina, Francisca, Albero, Patricia B, Cardozo, Carlos, Mòdol, Josep M, Aguirre, Alfons, Gaya, Ruth, Adroher, María, Llauger, Lluís, Díaz, Juan J L, González, Nayra C, Aragües, Paula L, Gómez, Ana P, Del Castillo, Juan G
• Format: Journal Article
• Language: English
• Published: England 01.06.2021
• Subjects: Adult; Age Factors; Aged; Case-Control Studies; Comorbidity; COVID-19 - diagnosis; COVID-19 - epidemiology; Emergency Service, Hospital; Female; Humans; Incidence; Male; Middle Aged; Pulmonary Embolism - epidemiology; Retrospective Studies; Risk Assessment; Risk Factors; Spain; Venous Thromboembolism - diagnosis; Venous Thromboembolism - epidemiology; Spain
• ISSN: 1473-5695
• DOI: 10.1097/MEJ.0000000000000783

A higher incidence of venous thromboembolism [both pulmonary embolism and deep vein thrombosis (DVT)] in patients with coronavirus disease 2019 (COVID-19) has been described. But little is known about the true frequency of DVT in patients who attend emergency department (ED) and are diagnosed with COVID-19. We investigated the incidence, risk factors, clinical characteristics and outcomes of DVT in patients with COVID-19 attending the ED before hospitalization. We retrospectively reviewed all COVID patients diagnosed with DVT in 62 Spanish EDs (20% of Spanish EDs, case group) during the first 2 months of the COVID-19 outbreak. We compared DVT-COVID-19 patients with COVID-19 without DVT patients (control group). Relative frequencies of DVT were estimated in COVID and non-COVID patients visiting the ED and annual standardized incidences were estimated for both populations. Sixty-three patient characteristics and four outcomes were compared between cases and controls. We identified 112 DVT in 74 814 patients with COVID-19 attending the ED [1.50‰; 95% confidence interval (CI), 1.23-1.80‰]. This relative frequency was similar than that observed in non-COVID patients [2109/1 388 879; 1.52‰; 95% CI, 1.45-1.69‰; odds ratio (OR) = 0.98 [0.82-1.19]. Standardized incidence of DVT was higher in COVID patients (98,38 versus 42,93/100,000/year; OR, 2.20; 95% CI, 2.03-2.38). In COVID patients, the clinical characteristics associated with a higher risk of presenting DVT were older age and having a history of venous thromboembolism, recent surgery/immobilization and hypertension; chest pain and desaturation at ED arrival and some analytical disturbances were also more frequently seen, d-dimer >5000 ng/mL being the strongest. After adjustment for age and sex, hospitalization, ICU admission and prolonged hospitalization were more frequent in cases than controls, whereas mortality was similar (OR, 1.37; 95% CI, 0.77-2.45). DVT was an unusual form of COVID presentation in COVID patients but was associated with a worse prognosis.