Association between Risk of VTE and Mortality in Patients with COVID-19

Objectives

To investigate the association between risk of venous thromboembolism (VTE) with 30-day mortality in COVID-19 patients.

Methods

1030 COVID-19 patients were retrospective collected, with baseline data on demographics, Sequential Organ Failure Assessment (SOFA) score, and VTE risk assessment models (RAMs) including Padua Prediction Score (PPS), International Medical Prevention Registry (IMPROVE) and Caprini RAM.

Results

Thirty-day mortality increased progressively from 2% in patients at low risk of VTE to 63% in those at high risk defined by PPS. Similar findings were also observed by IMPROVE and Caprini score. Progressive increases in VTE risk also were associated with higher SOFA score. The presence of high risk of VTE was independently associated with mortality regardless of adjusted gender, smoking status and some comorbidities with hazard ratios of 29.19, 37.37, 20.60 for PPS, IMPROVE and Caprini RAM, respectively (P < 0.001 for all comparisons). Predictive accuracy of PPS (Area Under Curve, AUC, 0.900), IMPROVE (AUC, 0.917) or Caprini RAM (AUC, 0.861) as the risk of mortality was markedly well.

Conclusions

We firstly investigate that the presence of high risk of VTE identifies a group of COVID-19 patients at higher risk for mortality. Furthermore, there is higher accuracy of VTE RAMs to predict mortality in these patients.