Thrombotic risk of hospitalized patients with COVID-19 and a co-infection

Background : Coronavirus disease 2019 (COVID-19) has emerged as a worldwide health crisis characterized by high rates of thrombotic events and increased inflammatory markers. It is likely that co-infections alongside COVID-19 increase the likelihood of the occurrence of a thrombotic event, however this information is unknown. Aims : To assess the association between co-infections and thrombotic events among hospitalized COVID-19 patients who received a non-malignant hematology consult. Methods : This was a retrospective observational chart review that evaluated 80 hospitalized patients with COVID-19 infection at a single institution who received a non-malignant hematology consult between 3/15/2020-5/30/2020. Multivariable logistic regression analyses were performed to examine the association between a coinfected patient and thrombotic event. Patients with a co-infection were only included in study analyses if their co-infection was diagnosed no later than 48 h post-thrombotic event. Results : Of the 80 patients, 69 met eligibility criteria and were on average, 56 years of age and majority Hispanic. Fifty-nine percent ( n = 41) had a co-infection and 36.59% ( n = 15) experienced a thrombotic event compared to 35.71% ( n = 10) without a co-infection ( P = 0.941, Table 1). The likelihood of a co-infected patient experiencing a thrombotic event was 2.91 times that of a patient without a co-infection ( P = 0.135, Table 2). Eighty-five percent ( n = 59) of all patients received anticoagulation on admission with no difference between patients who did and did not have a co-infection ( P = 0.968). Conclusions : We did not find a significant increase of thrombotic events in patients who had a co-infection compared to those without. Limitations include, small sample size, single-institution study, and sample restricted to a sub-specialized service. Patients with presumed thrombotic events (i.e., without objective documentation of thrombosis) were also not included. Future research with larger sample sizes is needed to clarify the association between co-infection and thrombotic events in COVID-19 infected patients.