Thrombotic and hemorrhagic complications in patients with severe and extremely severe COVID-19

Abstract

Objective. To analyze the incidence and structure of thrombotic and hemorrhagic intensive care unit (ICU) with severe and extremely COVID-19. Material and methods. A retrospective single-center study included 442 consecutive intensive care unit patients with severe and extremely severe COVID-19. Results. Thrombotic complications occurred in 87 (19.7%) out of 442 patients. Thrombosis of deep and superficial veins of the lower extremities prevailed (n=42;9.5%). Arterial thrombotic complications were observed in 34 (7.7%) patients. Stroke (n=19;4.3%) and myocardial infarction (n=11;2.5%) prevailed among these ones. Respiratory therapy and norepinephrine infusion were more common in patients with thrombotic complications compared to those without thrombotic complications. These patients were characterized by prolonged ICU-and hospital-stay. Patients with thrombotic complications had higher concentrations of ferritin, C-reactive protein and troponin T at admission to ICU. According to thromboelastography data, patients with thrombotic complications had a hypercoagulable profile without significant between-group differences. Hemorrhagic complications developed in 23 patients (5.2%) including major bleeding in 15 cases. Gastrointestinal bleeding was the most common. Conclusion. Patients with severe and extremely severe COVID-19 have a high incidence of thrombotic and hemorrhagic complications. Prospective randomized trials are warranted to elucidate the risk-benefit ratio of different anticoagulation strategies in ICU patients with new coronavirus infection. © 2022, Media Sphera Publishing Group. All rights reserved.