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dcyphr | Incidence of thrombotic complications in critically ill ICU patients with COVID-19

Introduction

Patients are at risk for many cardiovascular complications due to COVID-19. Such diseases include excessive inflammation, lack of oxygen, inability to move, and diffuse intravascular coagulation (DIC). DIC is when small clots build up throughout the body. Thrombosis is when a blood clot forms and blocks a blood vessel. 

Methods

Patients in this study were from three different Dutch hospitals. All had COVID-19 pneumonia. They all received varying amounts of thrombophylaxis. Thrombophylaxis is anything that prevents blood clot formation. Doses increased over time as complications increased. Physicians used CT pulmonary angiography and ultrasonography to detect thrombotic complications.

Results

Overall, 31 percent of patients developed complications even with thrombophylaxis (Figure 1). 27 percent of the patients developed venous thromboembolism. 3.7 percent of patients developed clots in the artery. Of these patients, 81 percent of them experienced pulmonary embolisms. Age and coagulopathy were independent factors in complications. Coagulopathy is when the body cannot form clots. Physicians did not find small clots (DIC) in any of the patients.

Conclusions

The numbers in this study are an underestimate of the total cases of thrombotic complications. Most patients still remain in the ICU. There are also strict restrictions on testing for venous thromboembolism in intubated patients. Because of the high amount of thrombotic complications, the physicians recommend all ICU patients with COVID-19 receive thrombophylaxis. The doses should be given in increasing amounts. Furthermore, more tests for thrombotic complications should be done at a lower threshold.