Analysis of Risk Factors for the Thromboembolic Events from 88 Patients with COVID-19 Pneumonia in Wuhan, China: A Retrospective Report

Background: Since the outbreak of COVID-19 in December 2019, there have been 81,238 confirmed cases and 3,250 deaths by March 19 in China. We aimed to analyze the risk factors and the incidence of thrombosis from patients confirmed COVID-19. Methods: In this study, we retrospectively report on 88 inpatients with confirmed COVID-19 at Wuhan Union Hospital (30 critical cases, 33 severe cases and 25 common cases). The thrombosis risk factor assessment, laboratory results, ultrasonographic findings and prognosis of the 88 patients were analyzed and compared among groups with different severity. Findings: There were 19 cases developed DVT (12 critical cases, 7 severe cases and none common cases) and one severe case eventually diagnosed with pulmonary thromboembolism (PTE). The 18 dead critical cases exhibited a Padua score increase (≥4), and 88.9% (16/18) of them also exhibited a D-dimer value increase (≥5 µg/ml). A positive correlation was observed between the increase in D-dimer value (≥5 µg/ml) and the severity of COVID-19 (r: 0·679, P <0·01), and between the the high Padua score (≥4) and the severity (r: 0·799, P <0·01). Univariable logistic regression showed an increasing odd of DVT with D-dimer greater than or equal to 5 µg/ml (Crude odds ratio [OR]: 4·539, 95% confidence interval [CI]: 1·289-15·991, P <0·05). Interpretation: Our report illustrates that D-dimer screening and Padua score assessment is helpful in the prevention of thrombosis. It may be more beneficial to perform early Doppler ultrasound of the lower limbs in every patient with critical COVID-19. Funding Statement: This study was supported by the funds from National Natural Science Foundation of China (NO. 81700021). Declaration of Interests: The authors have no conflicts of interest to declare. Ethics Approval Statement: This study was approved by Institutional Research Ethics Boards of the Union Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan.