Trends in venous thromboembolism and death in COVID-19 positive patients in 2020

Background: COVID-19 infections in 2020 led to numerous healthcare challenges with rapidly evolving treatments. It is unclear whether evolving treatment regimens and an increased focus on venous thromboembolism (VTE) prevention have improved outcomes. Aims: Evaluate trends in VTE and death in COVID-19 infected patients. Methods: COVID-19 PCR positive patients ≥ 18 years of age tested between 1/1/2020 through 12/31/2020 were retrospectively analyzed using electronic medical records across the Mayo Clinic enterprise. VTE outcomes (upper and lower extremity DVT and pulmonary emboli) were assessed from radiology reports using validated Natural Language Processing (NLP) algorithms. Results: 54,345 patients with COVID-19 were evaluated with 3871 (7.1%) having associated hospital admission within 30 days of the first positive test. The median age was 43 (IQR 28-58) and 51% were male. A total of 312 VTE events (0.57%) and 429 deaths (0.79%) occurred in the first 30 days after the COVID-19 positive test. 303 (97.1%) of the VTE events occurred in patients with a hospitalization within 30 days (before or after testing). Monthly frequencies of VTE varied between 0.40-1.1% and death varied between 0.56-2.0% (Figure 1). The risk of hospitalization, death, and VTE increased with age (Figure 2). Although hospitalization for COVID-19 has continued to decrease, frequencies of VTE and death have remained largely similar since June and did not significantly worsen with the surge in cases in the last quarter of 2020. (Figure Presented) Conclusions: The risk of VTE and death among all patients with COVID-19 positive PCR testing is low but increases significantly with age. The frequency of VTE and death has remained largely unchanged since June with the data highlighting the need for more effective management strategies in those over 60 years old.