Semin Thromb Hemost 2021; 47(04): 351-361
DOI: 10.1055/s-0040-1718402
Review Article

Presenting Characteristics, Treatment Patterns, and Outcomes among Patients with Venous Thromboembolism during Hospitalization for COVID-19

Carmen Fernández-Capitán
1   Department of Internal Medicine, Hospital Universitario La Paz, Madrid, Spain
Raquel Barba
2   Department of Internal Medicine, Hospital Rey Juan Carlos, Madrid, Spain
María del Carmen Díaz-Pedroche
3   Department of Internal Medicine, Hospital Universitario 12 de Octubre, Madrid, Spain
Patricia Sigüenza
4   Department of Internal Medicine, Hospital Germans Trias I Pujol, Badalona, Barcelona, Spain
Pablo Demelo-Rodriguez
5   Department of Internal Medicine, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Carmine Siniscalchi
6   Department of Internal and Emergency Medicine, Angiology Unit, Parma University Hospital, Parma, Italy
José María Pedrajas
7   Department of Internal Medicine, Hospital Clínico San Carlos, Madrid, Spain
Ana I. Farfán-Sedano
8   Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
Pavel Eduardo Olivera
9   Department of Hematology, Hospital Universitari Sagrat Cor, Barcelona, Spain
Covadonga Gómez-Cuervo
10   Department of Internal Medicine, Hospital Universitario 12 de Octubre, Madrid, Spain
Pilar Llamas
11   Department of Hematology, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
Paula Villares
12   Department of Internal Medicine, Hospital de Madrid Norte Sanchinarro. Madrid, Spain
Olivier Sanchez
13   Department of Pneumonology, Hôpital Europeen Georges Pompidou, Paris, France
Raquel López-Reyes
14   Department of Pneumonology, Hospital Universitari i Politècnic La Fe, Valencia, Spain
Judith Catella
15   Department of Internal Medicine, Hôpital Édouard Herriot, Lyon, France
Behnood Bikdeli
16   Department of Cardiology, Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
17   Department of Cardiology, Yale/YNHH Center for Outcomes Research & Evaluation, New Haven, Connecticut
18   Department of Cardiology, Cardiovascular Research Foundation, New York, New York
Ido Weinberg
19   Department of Cardiology, Massachusetts General Hospital, Boston, Massachusetts
Alfonso J. Tafur
20   Department of Medicine and Vascular Medicine, Evanston NorthShore University Health System, Evanston, Illinois
David Jiménez
21   Respiratory Department, Hospital Ramón y Cajal (IRYCIS), Madrid, Spain
22   Medicine Department, Universidad de Alcalá (IRYCIS), Madrid, Spain
23   CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.
Manuel Monreal
24   Department of Internal Medicine, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain
25   Catedra de enfermedad tromboembólica, Universidad Católica de Murcia, Spain
26   CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
› Author Affiliations
Funding This study was supported by Sanofi Spain with an unrestricted educational grant. The funders had no role in the design, conduct, or analyses, or the decision to submit this study.


Venous thromboembolism (VTE) is common in patients with coronavirus disease-2019 (COVID-19). However, limited data exist on patient characteristics, treatments, and outcomes. To describe the clinical characteristics, treatment patterns, and short-term outcomes of patients diagnosed with VTE during hospitalization for COVID-19. This is a prospective multinational study of patients with incident VTE during the course of hospitalization for COVID-19. Data were obtained from the Registro Informatizado de la Enfermedad TromboEmbólica (RIETE) registry. All-cause mortality, VTE recurrences, and major bleeding during the first 10 days were separately investigated for patients in hospital wards versus those in intensive care units (ICUs). As of May 03, 2020, a total number of 455 patients were diagnosed with VTE (83% pulmonary embolism, 17% isolated deep vein thrombosis) during their hospital stay; 71% were male, the median age was 65 (interquartile range, 55–74) years. Most patients (68%) were hospitalized in medical wards, and 145 in ICUs. Three hundred and seventeen (88%; 95% confidence interval [CI]: 84–91%) patients were receiving thromboprophylaxis at the time of VTE diagnosis. Most patients (88%) received therapeutic low-molecular-weight heparin, and 15 (3.6%) received reperfusion therapies. Among 420 patients with complete 10-day follow-up, 51 (12%; 95% CI: 9.3–15%) died, no patient recurred, and 12 (2.9%; 95% CI: 1.6–4.8%) experienced major bleeding. The 10-day mortality rate was 9.1% (95% CI: 6.1–13%) among patients in hospital wards and 19% (95% CI: 13–26%) among those in ICUs. This study provides characteristics and early outcomes of patients diagnosed with acute VTE during hospitalization for COVID-19. Additional studies are needed to identify the optimal strategies to prevent VTE and to mitigate adverse outcomes associated.

* A full list of RIETE investigators is given in Appendix 1.

Publication History

Article published online:
21 October 2020

© 2020. Thieme. All rights reserved.

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