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INVESTIGATING THE VENOUS THROMBOEMBOLISM AND HEMORRHAGIC COMPLICATIONS IN CRITICALLY ILL PATIENTS WITH COVID-19 AT THE 5G FIELD HOSPITAL
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Abstract
Objectives: This study aims to investigate the rate and risk factors of venous thromboembolism and hemorrhagic complications in critically ill COVID-19 patients. Subjects and methods: 98 critically ill COVID-19; diagnosed and graded according to WHO bleeding; of which 43 patients underwent doppler ultrasound assessment of VTE, acute pulmonary embolism was diagnosed according to the ESC in 2014. Results: hemorrhage occurred in 21.4% of critically ill COVID-19 patients; mostly grade 1 and grade 2 bleeding, accounting for 11.3% and 7.1%, respectively; grade 3 was 2.0% and grade 4 was 1.0%. Administration of anticoagulants at intermediate and therapeutic doses increased the risk of bleeding. The incidence of pulmonary embolism and deep venous thromboembolism (VTE) among 43 critical COVID-19 patients were 11.63% and 37.21%, respectively. The elevated levels of D-dimer and CRP at the admission time were the risk factors for VTE. The Area under the ROC curves (AUC) of D-dimer and CRP for VTE were 0.840 (p< 0.05) and 0.743 (p< 0.05), respectively. Conclusions: hemorrhagic complications were common in critically ill COVID-19 patients, mostly mild hemorrhage. The rate of PE and VTE of critical COVID-19 patients were 37.21% and 11.63%, respectively. D-dimer and CRP test at the admission time have prognostic value for venous thromboembolism in critical COVID-19 patients.
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Keywords
COVID-19, anticoagulation, hemorrhage, deep venous thromboembolism, pulmonary embolism
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