Thromboembolism Risk and Management in Hospitalized COVID-19 Patients: A Single-Center Experience in Ethiopia

Abstract

COVID-19 predisposes patients to venous thromboembolism (VTE) due to excessive inflammation, hypoxia, immobilization, diffuse  intravascular coagulation (DIC), and pulmonary thrombotic microangiopathy. COVID-19 patients who developed VTE were at a higher risk  of developing complications and death than those who did not. This study aimed to evaluate the risk, incidence, and management of  VTE in hospitalized COVID-19 patients at Tikur Anbessa Specialized Hospital (TASH), Addis Ababa, Ethiopia. A crosssectional  retrospective study was conducted among 146 COVID-19 patients admitted to TASH. The modified Caprini risk score was used to assess  the risk of VTE in COVID-19 patients. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 25. Of the 146  patients included in the study, 84 (57.53%) were males and the age was between 18 and 89 (mean 45.56 ± 18.17) years. More than one- third of the patients (69.2%) had a ≥ 5 VTE risk score for developing VTE, with a mean score of 3.63 ± 0.60. The most frequently observed  VTE risk factors were symptomatic COVID-19 (88.40%), serious lung disease (56.2%), and age > 40 years (52.10%). Thromboprophylaxis  was prescribed to 98 patients (67.12 %). The incidence of VTE was 15.75%, and most patients (91.3%) had the highest VTE risk (score ≥ 5).  It can be concluded that all patients with COVID-19 were at risk of developing VTE, with low utilization of thromboprophylaxis. The  incidence of VTE was high and majorly occurred in patients who did not receive prophylaxis. Radiological methods should be used to  diagnose VTE for optimizing its diagnosis and management.