Association Between Risk of VTE and Mortality in Patients with COVID-19

Background: Hospitalized patients with COVID-19 appeared high risk of venous thromboembolism (VTE), which exhibited the predictor of mortality in non-COVID-19 patients. Objectives: We aimed to investigate the association between risk of VTE with 30-day mortality in COVID-19 patients.Methods: In this retrospective cohort study, 1030 consecutive hospitalized patients with COVID-19 were recruited in two hospitals of Wuhan, China. We collected baseline data on demographics, SOFA parameters, and VTE risk assessment models (RAMs) including Padua Prediction Score (PPS), IMPROVE and Caprini RAM. The primary outcome of the study was 30-day mortality. Results: Thirty-day mortality increased progressively from 2% in patients at low risk of VTE to 63% in those at high risk defined by PPS. Similar findings were also observed for risk of VTE defined by IMPROVE and Caprini score. Progressive increases in VTE risk also were associated with higher SOFA score. Our findings showed that the presence of high risk of VTE was independently associated with 30-day mortality regardless of adjusted gender, smoking status and some comorbidities with hazard ratios of 29.19, 37.37, 20.60 for PPS, IMPROVE and Caprini RAM, respectively (P< 0.001 for all comparisons). Predictive accuracy of PPS (AUC, 0.900), IMPROVE (AUC, 0.917) or Caprini RAM (AUC, 0.861) as the risk of 30-day mortality was markedly well.Conclusions: The presence of high risk of VTE identifies a group of patients with COVID-19 at higher risk for 30-day mortality. Furthermore, there is higher accuracy of VTE RAMs to predict 30-day mortality in these patients.