COVID-19: High risk of thrombosis and pulmonary embolism in SARS-CoV-2 infection

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According to a recent announcement of the Medical University (MedUni) Vienna, researchers from the University Clinic for Internal Medicine I, Clinical Department of Hematology and Hemostaseology, were able to determine for the first time precise data on the risk of thrombosis in hospitalized COVID-19 patients in a systematic review of all worldwide published data on the topic “Thrombosis and Pulmonary Embolism in COVID-19 Patients”.

At the beginning of the pandemic, the coronavirus SARS-CoV-2 was often referred to as the respiratory virus. But in the meantime, scientific studies have shown that the novel pathogen is a “multi-organ virus” that attacks many organs and often leads to thromboses and pulmonary embolisms. This is also confirmed by a new study.

Soon after the beginning of the corona pandemic, scientists reported an increased rate of leg vein thrombosis and pulmonary embolism in patients with COVID-19. A new study now confirms this high risk.

Thromboses and pulmonary embolisms in corona

While patients who require in-patient care but do not need intensive care have a risk of five to eleven percent, between 18 and 28 percent of COVID-19 patients with a severe course suffer from leg vein thrombosis or pulmonary embolism.

The study results were recently published in the journal “Research and Practice in Thrombosis and Haemostasis” (RPTH).

“Already at the beginning of the COVID 19 pandemic, some studies reported an increased rate of thrombosis and pulmonary embolism. On the basis of this, but without corresponding evidence from controlled intervention studies, international therapy concepts were drawn up and a forced administration of blood-thinning drugs was recommended,” explains study leader Cihan Ay.

Exact data on thrombosis risk determined

“Our study now serves to better understand this risk and should help to make individual therapy decisions in the individual patient groups based on an accurate risk assessment.

For this review, the researchers analyzed and reviewed a total of 5,951 studies, 86 of which reported on thrombosis and pulmonary embolism rates in COVID-19 patients. Of these, 66 studies (28,173 patients) could be used for a meta-analysis to calculate a robust assessment of the risk of thrombosis.

However, a certain heterogeneity was observed in the subgroups. While the VTE rate of 23 percent was highest among COVID-19 patients requiring intensive care, the VTE rate was 8 percent among patients on the normal ward, a risk that is higher than for patients with other internal diseases who are otherwise hospitalized.

The researchers found that the overall prevalence of venous thromboembolism (VTE) was 14 percent, although thrombosis prophylaxis was administered in many of the studies.

This recently underlines the impact of COVID-19 on the blood clotting system. In addition, it has been shown that patients who have developed thrombosis or pulmonary embolism during the course of the disease have a significantly increased D-dimer at hospital admission, a laboratory value indicating an activated coagulation system.

According to the scientists, these findings now provide a basis for estimating the risk of thrombosis depending on the severity of COVID-19 disease. In future studies it must be shown whether an increased D-dimer at hospital admission justifies an intensification of blood thinning. (ad)

The result: “This risk is significantly increased compared to other serious diseases and lies between 10 and 18% in patients who require intensive medical care. Surprisingly, almost half of the COVID-19 in-patients who underwent systematic ultrasound thrombosis screening were also found to have thrombosis”.

Another special focus of the meta-analysis was the assessment of the risk of a potentially life-threatening pulmonary embolism.

WashingtonNewsday Health and Wellness.

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