Affiliation:
1. Institute of Health Systems Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York, United States
2. Department of Vascular Surgery, University of Thessaly, Larissa, Greece
3. Department of Medicine, Anticoagulation and Clinical Thrombosis Services, Northwell Health at Lenox Hill Hospital, New York, New York, United States
4. Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, United States
5. Department of Anesthesiology, University of Thessaly, Larissa, Greece
Abstract
Background Coronavirus disease 2019 (COVID-19) is associated with venous and arterial thromboembolism (VTE and ATE) and all-cause mortality (ACM) in hospitalized patients. High-quality data are needed on postdischarge outcomes in patients with cardiovascular disease.
Objectives To analyze outcomes and identify risk factors for ATE, VTE, and ACM in a high-risk subgroup of hospitalized COVID-19 patients with baseline cardiovascular disease.
Methods We investigated postdischarge rates and associated risk factors of ATE, VTE, and ACM in 608 hospitalized COVID-19 patients with coronary artery disease, carotid artery stenosis (CAS), peripheral arterial disease (PAD), or ischemic stroke.
Results Through 90 days postdischarge, outcome rates were: ATE 27.3% (10.2% myocardial infarction, 10.1% ischemic stroke, 13.2% systemic embolism, 12.7% major adverse limb event); VTE 6.9% (4.1% deep vein thrombosis, 3.6% pulmonary embolism); composite of ATE, VTE, or ACM 35.2% (214/608). Multivariate analysis showed significant association between this composite endpoint and age >75 years (odds ratio [OR]: 1.90, 95% confidence interval [CI]: 1.22–2.94, p = 0.004), PAD (OR: 3.23, 95% CI: 1.80–5.81, p ≤ 0.0001), CAS (OR: 1.74, 95% CI: 1.11–2.75, p = 0.017), congestive heart failure (CHF) (OR: 1.84, 95% CI: 1.02–3.35, p = 0.044), previous VTE (OR: 3.08, 95% CI: 1.75–5.42, p < 0.0001), and intensive care unit (ICU) admission (OR: 2.93, 95% CI: 1.81–4.75, p < 0.0001).
Conclusion COVID-19 inpatients with cardiovascular disease experience high rates of ATE, VTE, or ACM through 90 days postdischarge. Age >75 years, PAD, CAS, CHF, previous VTE, and ICU admission are independent risk factors.
Funder
Broxmeyer Fellowship in Clinical Thrombosis and Janssen Pharmaceuticals
National Institute on Aging
Hellenic Medical Society of New York
Cited by
3 articles.
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