Elderly patients with COVID-19 pneumonia with a history of diabetes, ischemic cardiovascular disease (CVD) and chronic liver disease (CLD) had an increased risk of thromboembolic events. These results were published in Annals of medicine and surgery.
This retrospective, observational cohort study evaluated the risk of thromboembolic events among patients (N = 46) with COVID-19 pneumonia admitted to Mogadishu Somali Turkish Training and Research Hospital in January and February 2020. Thromboembolic events included pulmonary embolism and deep vein thrombosis (DVT). ultrasound of the entire leg and CT angiography of the chest. The researchers evaluated results among patients with reported thromboembolic events versus those with reported non-thromboembolic events (controls).
The study population included 63% men, and the majority of patients (34.8%) were between 25 and 39 years old.
Among patients included in the study, thromboembolic events occurred in 41.3%. The researchers found that thromboembolic events were more likely to occur among patients older than 65 years, as well as those with ischemic cardiovascular disease (CVD).P = .003), CLD (P = .03) and diabetes (P = .025). The most common events included cerebrovascular accident in 15.22%, pulmonary embolism in 13.04%, acute myocardial infarction in 8.70% and DVT in 4.35%.
Compared with patients in the control group, the incidence of headache (21.7% vs 13%), chest pain (28.3% vs 4.3%), altered consciousness (17.4% vs 4.3%) and hemiplegia ( 15.2% vs 2.2%) increased among those with reported thromboembolic events (all P ≤.043).
Results of CT angiography of the breast showed that patients with reported thromboembolic events compared to those in the control group had an increased incidence of linear opacities (13% vs 2.2%), pleural effusion (11% vs. 4.3%), lymphadenopathy ( 8.7% vs 6.5%) and cavitation (8.7% vs. 2.2%). It should be noted that only the increased rate of linear opacity among patients with reported thromboembolic events were statistically significant (P = .015).
Compared to those in the control group, more patients with reported thromboembolic events experienced anticoagulants (41.3% vs. 15.2%) and required invasive mechanical ventilation (19.6% vs. 6.5%; P = 0.008). In addition, mortality occurred among 6 patients with reported thromboembolic events vs. 1 in the control group.
This study was limited by its small sample size.
According to the researchers, “further studies are needed to uncover systemic … risk factors” associated with the incidence of thromboembolic events among patients with COVID-19 pneumonia.
Mohamud MFY, Mukhtar MS. Epidemiological characteristics, clinical relevance and risk factors for thromboembolic complications in patients with COVID-19 pneumonia in a teaching hospital: retrospective observational study. Ann Med Surg. 2022; 77: 103660. doi: 10.1016 / j.amsu.2022.103660