Incidence of Venous Thromboembolism (VTE) in COVID-19: An Experience From A Single Large Academic Center

BACKGROUND: Novel severe acute respiratory coronavirus 2 (SARS-CoV2) has been associated with a hypercoagulable state Emerging literature from China and Europe has consistently shown an increased incidence of venous thromboembolism (VTE) We aim to identify the VTE incidence and early predictors of VTE at our high-volume tertiary care center METHODS: We performed a retrospective cohort study of patients admitted to Temple University Hospital with COVID-19 We first identified VTE [pulmonary embolism (PE) and deep vein thrombosis (DVT)] incidence in our cohort VTE and no VTE groups were compared in univariable analysis for demographics, co-morbidities, laboratory data, and treatment outcomes Subsequently, multivariable logistic regression analysis was performed to identify early predictors of VTE RESULTS: 147 patients admitted to Temple University Hospital, between April 1st, 2020 to April 27th, 2020 to designated COVID 19 unit with a high clinical suspicion for acute VTE were tested with either CT pulmonary angiogram and/or extremity venous duplex, representing 20 9% of all admissions The overall incidence of VTE was 17% (25/147) There were 16 cases of acute PE, 14 cases of acute DVT, and 5 patients with both PE and DVT The need for invasive mechanical ventilation (adjusted OR 3 19, 95% CI:1 07-9 55), admission D-dimer level > 1,500 ng/mL (aOR 3 55, 95% CI:1 29-9 78) were independent markers associated with VTE occurence All-cause mortality in the VTE group was higher (48% vs 22%, p=0 007) than no VTE group CONCLUSION: Our data represents one of the earliest published US reports on the incidence rate of VTE in COVID-19 Patients with high clinical suspicion and identified risk factors (need for invasive mechanical ventilation, D-dimer on admission > 1,500 ng/mL can be considered for early VTE testing We did not screen all patients admitted for VTE, therefore it is possible the true incidence of VTE was underestimated Our findings should be confirmed prospectively in future studies