Assessing Thromboembolic Complications and In-Hospital Mortality and Clinical Factors Affecting Thromboembolic Complications in COVID-19 stage 3-5 ICU cases

• Published in: JOURNAL OF RESEARCH IN PHARMACY
• Main Authors: Rosli, Wan Nur Maisarah Wan; Ravi, Tharmini; Ming, Long Chiau; Zulkifly, Hanis Hanum
• Format: Article
• Language: English
• Published: MARMARA UNIV 2024
• Subjects: Pharmacology & Pharmacy
• Online Access: https://www-webofscience-com.uitm.idm.oclc.org/wos/woscc/full-record/WOS:001288934400031

Background: Thromboembolic (TE) complications are associated with the severity of the infection and are no less of a disease that contributes to the fatality of critically ill patients infected with COVID-19. Objective: This study aimed to investigate the prevalence of TE complications, in-hospital mortality, and risk factors among ICU patients (stage 3, 4, 5) infected with COVID-19. Methodology: In this retrospective single-center cross-sectional study, 106 severe patients referred to intensive care units (ICUs) due to COVID-19 between February 2021 and December 2022 were included. All patients received a thromboprophylaxis agent. Results: Mean (SD) age 49.81(13.27), 50.9% were male, 68.9% Malays, mean (SD) (2-12) days of ICU admission with the most coexisting comorbidities being hypertension (44.3%), diabetes mellitus (33%), and obesity (60.3%). Of 106 patients, 51 (41.9%) developed pulmonary embolism (PE) and 27.5% died despite adequate thromboprophylaxis. In total, 51 (41.9%) developed TE event during their ICU admission. Significantly higher proportions of COVID-19 patients who developed complications of PE (77.8% vs 42%; p = 0.006) died. D-dimer, fibrinogen, white cell count (WCC), and troponin were significantly greater among those with TE events. Demographics, co-morbidities, other laboratory parameters and were similar in COVID19 patients with and without TE events. Conclusion: There is a high incidence of TE complications and in-hospital mortality in critically ill patients with COVID-19. A high level of D-dimer, fibrinogen, white cell count, and troponin were associated with in-hospital TE events. It is apparent that routine chemical thromboprophylaxis may not be sufficient to prevent TE complications in patients with severe COVID-19.