Macrovascular Thrombotic Events in a Mayo Clinic Enterprise-wide Sample of Hospitalized COVID-19 Positive Compared to Negative Patients

Chaudhary, Rahul; Padrnos, Leslie; Wysokinska, Ewa; Pruthi, Rajiv; Misra, Sanjay; Sridharan, Meera; Wysokinski, Waldemar; McBane, Robert D.; Houghton, Damon E.

Objective To determine the difference in the rate of thromboembolic complications between hospitalized COVID-19 positive compared COVID-19 negative patients. Methods Adult hospitalized patients with COVID-19 testing by PCR assay were identified through electronic health records across multiple hospitals in the Mayo Clinic Enterprise from 1/1/2020 through 5/8/2020. Thrombotic outcomes (venous and arterial) were identified from the hospital problem list. Results 3,790 hospitalized patients with COVID-19 testing were identified across 19 hospitals, among which 102 tested positive. The median age was lower in the COVID-positive patients (62 vs. 67, p=.02). The median length of hospitalization was longer in COVID-positive patients (9 vs. 4 days, p<.001) and more required ICU care (57.1% vs. 26.7%, p<.001). Comorbidities, including atrial fibrillation/flutter, heart failure, chronic kidney disease, and malignancy were observed less frequently with COVID-positive admissions. Any VTE was identified in 2.9% of COVID-positive and 4.6% of COVID-negative patients (p=.41). The frequency of venous and arterial events was not different between the groups. The unadjusted OR for COVID-positive patients for any VTE was 0.63 (95% CI 0.19-2.02). A multivariable logistic regression model evaluated death within 30 days of hospital discharge; neither COVID-positivity (aOR 1.02, 95% CI 0.49-2.11) nor thromboembolism (aOR 0.90, 95% CI 0.60-1.32) was associated with death. Conclusion Early experience with COVID-19 patients across multiple academic and regional hospitals representing different United States regions demonstrates a lower than previously reported incidence of thrombotic events. This incidence was not higher than a contemporary COVID-negative hospitalized comparator.