Postdischarge thrombosis and hemorrhage in patients with COVID-19

Blood. 2020 Sep 10;136(11):1342-1346. doi: 10.1182/blood.2020007938.

Abstract

Coronavirus disease 2019 (COVID-19) is associated with a prothrombotic state with a high incidence of thrombotic events during hospitalization; however, data examining rates of thrombosis after discharge are limited. We conducted a retrospective observational cohort study of discharged patients with confirmed COVID-19 not receiving anticoagulation. The cohort included 163 patients with median time from discharge to last recorded follow-up of 30 days (interquartile range [IQR], 17-46 days). The median duration of index hospitalization was 6 days (IQR, 3-12 days) and 26% required intensive care. The cumulative incidence of thrombosis (including arterial and venous events) at day 30 following discharge was 2.5% (95% confidence interval [CI], 0.8-7.6); the cumulative incidence of venous thromboembolism alone at day 30 postdischarge was 0.6% (95% CI, 0.1-4.6). The 30-day cumulative incidence of major hemorrhage was 0.7% (95% CI, 0.1-5.1) and of clinically relevant nonmajor bleeds was 2.9% (95% CI, 1.0-9.1). We conclude that the rates of thrombosis and hemorrhage appear to be similar following hospital discharge for COVID-19, emphasizing the need for randomized data to inform recommendations for universal postdischarge thromboprophylaxis.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Betacoronavirus / isolation & purification*
  • COVID-19
  • Coronavirus Infections / complications*
  • Coronavirus Infections / virology
  • Female
  • Follow-Up Studies
  • Hemorrhage / etiology*
  • Hemorrhage / pathology
  • Humans
  • Male
  • Middle Aged
  • Pandemics
  • Patient Discharge / statistics & numerical data*
  • Pneumonia, Viral / complications*
  • Pneumonia, Viral / virology
  • Prognosis
  • Retrospective Studies
  • SARS-CoV-2
  • Thrombosis / etiology*
  • Thrombosis / pathology
  • Young Adult