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Open Access
CC BY 4.0 · TH Open 2022; 06(04): e408-e420
DOI: 10.1055/a-1937-9692
Original Article

Occurrence of Thromboembolic Events and Mortality Among Hospitalized Coronavirus 2019 Patients: Large Observational Cohort Study of Electronic Health Records

Alex C. Spyropoulos 
1   Northwell Health at Lenox Hill Hospital, New York, New York, United States
2   The Institute of Health Systems Science at the Feinstein Institutes for Medical Research, Manhasset, New York, United States
3   The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, United States
,
James M. Crawford
2   The Institute of Health Systems Science at the Feinstein Institutes for Medical Research, Manhasset, New York, United States
3   The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, United States
,
Yen-Wen Cindy Chen
4   Janssen Scientific Affairs, LLC, Titusville, New Jersey, United States
,
Veronica Ashton
4   Janssen Scientific Affairs, LLC, Titusville, New Jersey, United States
,
Alicia K. Campbell
4   Janssen Scientific Affairs, LLC, Titusville, New Jersey, United States
,
Dejan Milentijevic
4   Janssen Scientific Affairs, LLC, Titusville, New Jersey, United States
,
W. Frank Peacock
5   Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, Texas, United States
› Author Affiliations
Funding This work was supported by Janssen Scientific Affairs, LLC, United States.
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Abstract

Background Most symptoms of coronavirus 2019 (COVID-19) are mild; however, some patients experience cardiovascular complications, including thromboembolic events and death. Data are needed to better inform prevention and treatment of these events. This analysis was designed to describe patient characteristics, medication use, thromboembolic events, and all-cause mortality in hospitalized COVID-19 patients in the United States.

Methods This retrospective, observational cohort study identified adults hospitalized with COVID-19 (January 21, 2020–January 07, 2021) in the deidentified Optum COVID-19 Electronic Health Records dataset. Thromboembolic events and all-cause mortality were collected at any time during the variable follow-up period (up to 50 weeks).

Results Of 181,995 COVID-19 patients who met eligibility criteria, 40,524 (22.3%) were hospitalized with COVID-19. Hospitalized patients had a mean age of 63 years and a Quan–Charlson comorbidity index of 1.3. Anticoagulants were used in 89.2% of patients during hospitalization and in 18.7% of postdischarge patients. Of hospitalized patients, 17.6% had a thromboembolic event during the entire follow-up period (mean time to the first event of 15 days), of whom 13.4% had an event during hospitalization; of discharged patients, 4.3% had a thromboembolic event (mean time from discharge to event of 43 days). Death during the follow-up period was reported in 15.0% of patients.

Conclusions In this large, observational cohort study, patients hospitalized with COVID-19 had high rates of thromboembolic events during hospitalization and in the postdischarge period; mortality was also high in this population. Anticoagulant use was common during hospitalization. These findings support further studies to optimize in-hospital and extended prophylaxis for hospitalized COVID-19 patients.

Keywords

anticoagulants - COVID-19 - hospitalization - risk factors - thromboembolism

Data Availability

Data for these analyses were made available to the authors through third-party license from Optum, a commercial data provider. As such, the authors cannot make these data publicly available due to data use agreement. Other researchers can access these data by purchasing a license through Optum. Inclusion criteria specified in the Methods section would allow other researchers to identify the same cohort of patients we used for these analyses. Interested individuals may see https://www.optum.com/business/solutions/life-sciences/explore-data.html for more information on accessing Optum data.


Author Contributions

W.F.P., J.M.C., and A.C.S. contributed to the analysis and/or interpretation of data; critical writing or revising the intellectual content; and final approval of the version to be published. Y.-W.C., V.A., A.K.C., and D.M. contributed to the concept and design, analysis, and/or interpretation of data; critical writing or revising the intellectual content; and final approval of the version to be published.


Supplementary Material



Publication History

Received: 22 July 2022

Accepted: 30 August 2022

Accepted Manuscript online:
07 September 2022

Article published online:
18 November 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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