Venous thromboembolism prophylaxis in Asian patients with severe COVID-19: A prospective cohort study
Issued Date
2024-03-01
Resource Type
eISSN
26665727
Scopus ID
2-s2.0-85187342146
Journal Title
Thrombosis Update
Volume
14
Rights Holder(s)
SCOPUS
Bibliographic Citation
Thrombosis Update Vol.14 (2024)
Suggested Citation
Nanthatanti N., Chantrathammachart P., Thammavaranucupt K., Jayanama K., Supatrawiporn N., Phusanti S., Sungkanuparph S., Srichatrapimuk S., Kirdlarp S., Suppagungsuk S., Wongsinin T., Pitidhammabhorn D., Angchaisuksiri P. Venous thromboembolism prophylaxis in Asian patients with severe COVID-19: A prospective cohort study. Thrombosis Update Vol.14 (2024). doi:10.1016/j.tru.2024.100162 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/97660
Title
Venous thromboembolism prophylaxis in Asian patients with severe COVID-19: A prospective cohort study
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Corresponding Author(s)
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Abstract
The severe coronavirus disease 2019 (COVID-19) triggers various coagulation cascades, culminating in the manifestation of venous thromboembolism (VTE). The efficacy of anticoagulant prophylaxis in averting VTE occurrence in severe COVID-19 cases in Thailand remains uncertain. We aimed to determine the prevalence of symptomatic VTE in patients with severe COVID-19 who received a standard dose of anticoagulants and to evaluate the risk factors. Our prospective cohort study included patients with severe COVID-19 who received anticoagulant prophylaxis. VTE, bleeding events and mortality were monitored until 60 days after VTE prophylaxis initiation. Of the 250 study patients, pulmonary embolism was observed in 7.2% of patients. In a multivariate Cox regression model, endotracheal intubation [hazard ratio (HR) = 13.75; 95% confidence interval (CI) = 2.87–65.82; p = 0.001] and high D-dimer levels [HR = 1.052; 95% CI = 1.023–1.081; p < 0.001) were significantly associated with higher VTE risk within 60 days of VTE prophylaxis. Bleeding and major hemorrhage occurred in 35 (14%) and eight (3.2%) patients, respectively. These findings indicated that a standard dose of anticoagulant may not be sufficient for preventing thrombosis in patients who require intensive care. Further research on the appropriate dose is necessary.