Timing of venous thromboembolism diagnosis in hospitalized and non-hospitalized patients with COVID-19

• Published in: Thrombosis research Vol. 207; pp. 150 - 157
• Main Authors: Pasha, Ahmed K., McBane, Robert D., Chaudhary, Rahul, Padrnos, Leslie J., Wysokinska, Ewa, Pruthi, Rajiv, Ashrani, Aneel, Daniels, Paul, Sridharan, Meera, Wysokinski, Waldemar E., Houghton, Damon E.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Ltd 01.11.2021
• Subjects: COVID-19; Deep vein thrombosis; Pulmonary embolism; SARS-CoV-2; Venous thromboembolism; COVID-19; Pulmonary embolism; Deep vein thrombosis; SARS-CoV-2; Venous thromboembolism
• ISSN: 0049-3848; 1879-2472
• DOI: 10.1016/j.thromres.2021.09.021

The reported incidence of venous thromboembolism (VTE) in COVID-19 patients varies widely depending on patient populations sampled and has been predominately studied in hospitalized patients. The goal of this study was to assess the evolving burden of COVID-19 and the timing of associated VTE events in a systems-wide cohort. COVID-19 PCR positive hospitalized and non-hospitalized patients ≥18 years of age tested between 1/1/2020 through 12/31/2020 were retrospectively analyzed using electronic medical records from multiple states across the Mayo Clinic enterprise. Radiology reports within 90 days before and after confirmed COVID-19 diagnosis were examined for VTE outcomes using validated Natural Language Processing (NLP) algorithms. A 29-fold increased rate of VTE compared to the pre-COVID-19 period was noted during the first week following the first positive COVID-19 test (RR: 29.39; 95% CI 21.77-40.03). The rate of VTE steadily decreased and returned to baseline by the 6th week. Among 366 VTE events, most occurred during (n = 243, 66.3%) or after (n = 111, 30.3%) initial hospitalization. Only 11 VTE events were identified in patients who did not require hospitalization (3.0% of total VTE events). VTE and mortality increased with advancing age with a pronounced increased each decade in older patients. We observed a profoundly increased risk of VTE within the first week after positive testing for COVID-19 that returned to baseline levels after 6 weeks. VTE events occurred almost exclusively in patients who were hospitalized, with the majority of VTE events identified within the first days of hospitalization. •A 29-fold increase in VTE events was noted during the first week after COVID-19 positive PCR•The frequency of VTE was much higher for hospitalized patients compared to non-hospitalized patients (5.6% vs 0.02%).•VTE rate decreased to baseline pre-COVID-19 levels after 6-7 weeks