Follow-up after acute thrombotic events following COVID-19 infection

Abstract: Objective COVID-19 infection results in a hypercoagulable state predisposing patients to thrombotic events. We report the 3- and 6- month follow-up of 27 patients who experienced acute arterial thrombotic events in the setting of COVID-19 infection. Methods Data was prospectively collected and maintained for all vascular surgery consultations in the Mount Sinai Health System from patients who presented between March 16th and May 5th, 2020. Results 27 patients experienced arterial thrombotic events. Average length of stay was 13.3 ± 15.4 days. 14 patients were treated with open surgical intervention, 6 were treated with endovascular intervention, and 7 were treated with anticoagulation only. At 3-month follow-up, 11 patients (40.7%) were deceased. 9 patients who expired did so during the initial hospital stay. The 3-month cumulative primary patency rate for all interventions was 72.2%, and the 3-month primary patency rates for open surgical and endovascular interventions were 66.7 and 83.3 respectively. There were 9 (33.3%) readmissions within 3 months. 6-month follow-up was available in 25 (92.6%) patients. At 6-month follow-up, 12 (48.0%) patients were deceased, and the cumulative primary patency rate was 61.9%. The 6-month primary patency rates of open surgical and endovascular interventions were 66.7% and 55.6% respectively. The limb-salvage rate at both 3- and 6-months was 89.2%. Conclusion Patients with COVID-19 infections who experienced thrombotic events saw high complication and mortality rates with relatively low patency rates.