Venous Thromboembolism in COVID-19 Patients During the First and the Second Waves of the Pandemic: Real-Practice Data

Abstract

Objective. To analyze the incidence, structure, course and outcomes of venous thromboembolism (VTE) in patients with a novel coronavirus infection (COVID-19) during the first and the second waves of the pandemic, to identify and evaluate the features of laboratory data. Material and methods. We assessed instrumental and laboratory data in COVID-19 patients during the first (1839 patients) and the second (840 patients) waves of the pandemic. Mortality, localization of thrombosis, variants of anticoagulation and laboratory data (leukocytes, C-reactive protein, fibrinogen, ferritin) were analyzed. Results. VTE occurred in 27 (1.5%) and 13 (1.5%) patients with a novel coronavirus infection during the first and the second waves of the pandemic, respectively. In the first wave, thromboembolic events included deep vein thrombosis (DVT) in 16 (59%) cases, pulmonary embolism (PE) in 6 (22%) cases, DVT + PE in 2 (8%) patients, saphenous vein thrombophlebitis in 3 (11%) cases. In the second wave, DVT was detected in 5 (38.5%) patients, DVT+PE in 5 (38.5%) cases, PE without DVT in 2 (15.4%) patients and thrombosis of the right renal vein in 1 (7.6%) patient. In the first wave, mean leukocyte count was 9.2 x 109/L (6.9—14.3), C-reactive protein — 77.5 mg/L (26-159), fibrinogen — 593.5 mg/ml (500—700), ferritin — 1132.6 µ/L (165-1753). The second wave of the pandemic was characterized by moderate leukocytosis (12.2·109 /L (7—19)), increase of serum fibrinogen (544 mg/ ml (405—781)), C-reactive protein (102.75 mg/L (80—163)) and ferritin (510 μg/L (230—566)). Conclusion. VTE in patients with a new coronavirus infection is followed by high mortality. In the second wave of the pandemic, mortality of patients with VTE was higher that may be associated with both thrombotic complications and cardiovascular comorbidities.