Follow-up after acute thrombotic events following COVID-19 infection

J Vasc Surg. 2022 Feb;75(2):408-415.e1. doi: 10.1016/j.jvs.2021.08.092. Epub 2021 Sep 28.


Objective: COVID-19 infection results in a hypercoagulable state predisposing patients to thrombotic events. We report the 3- and 6-month follow-up of 27 patients who experienced acute arterial thrombotic events in the setting of COVID-19 infection.

Methods: Data were prospectively collected and maintained for all vascular surgery consultations in the Mount Sinai Health System from patients who presented between March 16 and May 5, 2020.

Results: Twenty-seven patients experienced arterial thrombotic events. The average length of stay was 13.3 ± 15.4 days. Fourteen patients were treated with open surgical intervention, six were treated with endovascular intervention, and seven were treated with anticoagulation only. At 3-month follow-up, 11 patients (40.7%) were deceased. Nine patients who expired did so during the initial hospital stay. The 3-month cumulative primary patency rate for all interventions was 72.2%, and the 3-month primary patency rates for open surgical and endovascular interventions were 66.7 and 83.3, respectively. There were 9 (33.3%) readmissions within 3 months. Six-month follow-up was available in 25 (92.6%) patients. At 6-month follow-up, 12 (48.0%) patients were deceased, and the cumulative primary patency rate was 61.9%. The 6-month primary patency rates of open surgical and endovascular interventions were 66.7% and 55.6%, respectively. The limb-salvage rate at both 3 and 6 months was 89.2%.

Conclusions: Patients with COVID-19 infections who experienced thrombotic events saw high complication and mortality rates with relatively low patency rates.

Keywords: Amputation; COVID-19; Limb ischemia; Patency; Thrombosis.

MeSH terms

  • Acute Disease
  • Aged
  • COVID-19 / complications*
  • COVID-19 / epidemiology
  • Computed Tomography Angiography
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Pandemics
  • Retrospective Studies
  • Risk Factors
  • SARS-CoV-2*
  • Thrombosis / diagnosis
  • Thrombosis / etiology*
  • Thrombosis / physiopathology
  • Vascular Patency / physiology*