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

Faries, Christopher M.; Rao, Ajit; Ilonzo, Nicole; Hwong, Songhon; Krishnan, Prakash; Farhan, Serdar; Ting, Windsor; Vouyouka, Ageliki G.; Tadros, Rami O.; Marin, Michael L.; Faries, Peter L.

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 was prospectively collected and maintained for all vascular surgery consultations in the Mount Sinai Health System from patients who presented between March 16th and May 5th, 2020. RESULTS: 27 patients experienced arterial thrombotic events. Average length of stay was 13.3 ± 15.4 days. 14 patients were treated with open surgical intervention, 6 were treated with endovascular intervention, and 7 were treated with anticoagulation only. At 3-month follow-up, 11 patients (40.7%) were deceased. 9 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. 6-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%. CONCLUSION: Patients with COVID-19 infections who experienced thrombotic events saw high complication and mortality rates with relatively low patency rates.