Assessment of risk factors for thrombosis in ICU patients with COVID-19

Abstract

<b>Introduction: </b>High incidence of thrombotic events has been reported in hospitalized patients with COVID-19. Less than 50% of pulmonary embolisms (PE) are associated with signs of deep vein thrombosis (DVT) of the lower extremities.<br /> <b>Objective:</b> To assess the risk factors of deep vein thrombosis (DVT) in intensive care patients with COVID-19 by comparing the clinical features of patients in groups with thrombosis, venous stasis and without deep vein thrombosis.<br /> <b>Material and methods:</b> A prospective cross-sectional study was conducted that included all consecutive adult patients with laboratory-confirmed COVID-19 admitted to the intensive care unit. We investigated chronic comorbid conditions in patients, including arterial hypertension, diabetes mellitus, obesity, chronic kidney failure (CRF), chronic obstructive pulmonary disease (COPD), chronic heart failure (CHF), and cancer which may be a risk factor for thrombosis.<br /> <b>Results: </b>A total of 465 patients were included in the study. Comorbidities were present in 435 of 465 patients (93.55%). Doppler ultrasound (DUS) confirmed deep vein thrombosis in 60 patients (13.8%), which was associated with older age (71.12±13.98 vs. (79.57%), chronic heart failure - 196 (42.15%), obesity - 161 (34.62%), diabetes mellitus - 144 (30.97%), chronic renal failure (CRF) -58 (12.47%) and oncological diseases - 25 (5.38%). Hypertension (p=0.02), diabetes mellitus (p=0.041) and obesity (p=0.01) were significant risk factors for DVT. D-dimer was a statistically significant predictor of DVT formation (p<0.001), an increase in D-dimer per unit increased the risk of DVT by 14%.<br /> <b>Conclusion:</b> The study identified risk factors for deep vein thrombosis in intensive care patients with COVID-19. These include: age, high levels of D-dimer, and comorbidities such as hypertension, obesity, and diabetes mellitus.