Editor-in-Chief Hatice Kübra Elçioğlu Vice Editors Levent Kabasakal Esra Tatar Online ISSN 2630-6344 Publisher Marmara University Frequency Bimonthly (Six issues / year) Abbreviation J.Res.Pharm. Former Name Marmara Pharmaceutical Journal
Journal of Research in Pharmacy 2024 , Vol 28 , Issue 4
Assessing Thromboembolic Complications and In- Hospital Mortality and Clinical Factors Affecting Thromboembolic Complications in COVID-19 stage 3-5 ICU cases
Wan Nur Maisarah Wan Rosli1,2,Tharmini Ravi3,4,Long Chiau Ming5,Hanis Hanum Zulkifly1,2
1Faculty of Pharmacy, Universiti Teknologi MARA, Kampus Puncak Alam, Selangor, Malaysia
2Cardiology Therapeutics Research Group, Universiti Teknologi MARA, Puncak Alam, Malaysia
3Hospital Sungai Buloh, Sungai Buloh, Selangor, Malaysia
4Clinical Research Center, Hospital Sungai Buloh, Sungai Buloh, Selangor, Malaysia
5School of Medical and Life Sciences, Sunway University, Sunway City, Malaysia
DOI : 10.29228/jrp.805 Background: Thromboembolic (TE) complications are associated with the severity of the infection and are no less of a disease that contributes to the fatality of critically ill patients infected with COVID-19. Objective: This study aimed to investigate the prevalence of TE complications, in-hospital mortality, and risk factors among ICU patients (stage 3, 4, 5) infected with COVID-19. Methodology: In this retrospective single-center cross-sectional study, 106 severe patients referred to intensive care units (ICUs) due to COVID-19 between February 2021 and December 2022 were included. All patients received a thromboprophylaxis agent. Results: Mean (SD) age 49.81(13.27), 50.9% were male, 68.9% Malays, mean (SD) (2-12) days of ICU admission with the most coexisting comorbidities being hypertension (44.3%), diabetes mellitus (33%), and obesity (60.3%). Of 106 patients, 51 (41.9%) developed pulmonary embolism (PE) and 27.5% died despite adequate thromboprophylaxis. In total, 51 (41.9%) developed TE event during their ICU admission. Significantly higher proportions of COVID-19 patients who developed complications of PE (77.8% vs 42%; p = 0.006) died. D-dimer, fibrinogen, white cell count (WCC), and troponin were significantly greater among those with TE events. Demographics, co-morbidities, other laboratory parameters and were similar in COVID- 19 patients with and without TE events. Conclusion: There is a high incidence of TE complications and in-hospital mortality in critically ill patients with COVID-19. A high level of D-dimer, fibrinogen, white cell count, and troponin were associated with in-hospital TE events. It is apparent that routine chemical thromboprophylaxis may not be sufficient to prevent TE complications in patients with severe COVID-19. Keywords : COVID-19; thromboembolic complications; venous thromboembolism; prevalence of pulmonary embolism; deep vein thrombosis; laboratory findings
Marmara University