engleski

Characteristics of venous thromboembolism following COVID-19 in Croatia

Introduction: Coronavirus disease 2019 (COVID-19) can lead to systemic activation of coagulation and thrombotic complications. Post–COVID-19 syndrome may involve sustained intrapulmonary activation of coagulation with ongoing pulmonary microthrombosis as a consequence. Aim: To evaluate clinical and epidemiological characteristics, as well as risk factors for venous thromboembolism (VTE) in patients following COVID-19 in Croatia. Materials and Methods: A retrospective analysis of 15 patients hospitalized in University Hospital “Sveti Duh”, Zagreb, Croatia, with a diagnosis of venous thromboembolism after COVID- 19 infection from December 2020 to January 2021. Inclusion criteria were: age of at least 18 years, a positive PCR test for a severe acute respiratory syndrome coronavirus 2 from a nasopharyngeal swab and a confi rmed diagnosis of deep vein thrombosis or pulmonary embolism. Results: We included 15 (n=15) patients (with median age 61 years, 53% men, 13% required hospital treatment for COVID-19 and 40% developed COVID-19 pneumonia). The median time from positive PCR test for Sars-Cov 2 virus to thrombotic event was 20 days (interquartile range, 1-32). Median MEWS score for COVID-19 disease was 1, 5 (interqaurtile range 0-4), and only women had high MEWS scores (3 or higher), while men had lower MEWS scores ranging from 0 to 2. 46% of patients presented with a deep vein thrombosis, 40% with a segmental pulmonary embolism, and 14% with a massive pulmonary embolism. 73% of patients had arterial hypertension, 33% had body mass index (BMI) over 30 kg/m2, 20% had asthma, 13% malignant diseaseas, and 13% diabetes. Thromboprophylaxis was used in 33% of patients during acute COVID-19 disease. All patients have been tested for thrombophilia, and results are expected. Conclusions: The risk of venous thromboembolism in patients with COVID-19 and post-COVID-19 syndrome is high. Our results show that venous thromboembolism following COVID- 19 occurs in women who have suff ered from a more severe form of the COVID-19 disease (according to MEWS score), in contrast to men, in whom it occurs more often after milder clinical pictures of COVID- 19. Our results show that arterial hypertension and high BMI are the most common risk factors for VTE following COVID-19. There is a need to improve prophylactic strategy to prevent VTE.

COVID-19 ; thromboembolism

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