Annals of vascular surgery · 2026
Deep Vein Thrombosis in Hospitalized Patients with COVID-19: Incidence, Distribution, Predictors, and Clinical Outcomes in a Brazilian Tertiary Center.
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Gonçalves Neves Osmar Max, Neves Lima Guilherme, Santos Nunes Paula, Aragão José Aderval, Antunes De Souza Araújo Adriano, Prado Reis Francisco
Аннотация
BACKGROUND: This study aimed to assess the incidence, anatomical distribution, and independent clinical predictors of deep vein thrombosis (DVT) among patients hospitalized with COVID-19 in a Brazilian tertiary-care center.
METHODS: This retrospective cohort study included 5,831 hospital admissions (2020-2024) with complete DVT data. Demographic characteristics, comorbidities, imaging findings, and clinical outcomes were analyzed. Independent predictors of DVT were identified using multivariable logistic regression and reported as adjusted odds ratios (aORs).
RESULTS: DVT was infrequent but strongly associated with COVID-19 severity. Patients with DVT had higher rates of intensive care unit admission, mechanical ventilation, prolonged hospitalization (median 24 vs. 8 days; P < 0.001), and in-hospital mortality (37.7% vs. 11.1%; P < 0.001). Pulmonary embolism was more common among patients with DVT (15.9% vs. 1.2%; P < 0.001). Independent predictors of DVT included prior DVT (aOR = 18.3; 95% confidence interval [CI], 5.22-63.9), obesity (aOR = 3.21; 95% CI, 1.92-5.38), smoking (aOR 2.59; 95% CI, 1.26-5.34), and oxygen requirement (aOR = 4.86; 95% CI, 2.35-10.1). Most events were acute and predominantly involved the left lower extremity.
CONCLUSION: Although uncommon, DVT in hospitalized COVID-19 patients was associated with substantial morbidity and mortality. A prior history of venous thrombosis was the strongest predictor, identifying a high-risk subgroup. The occurrence of clinically significant DVT despite routine pharmacological prophylaxis supports the need for risk-adapted diagnostic strategies, including targeted use of venous Doppler ultrasound.
METHODS: This retrospective cohort study included 5,831 hospital admissions (2020-2024) with complete DVT data. Demographic characteristics, comorbidities, imaging findings, and clinical outcomes were analyzed. Independent predictors of DVT were identified using multivariable logistic regression and reported as adjusted odds ratios (aORs).
RESULTS: DVT was infrequent but strongly associated with COVID-19 severity. Patients with DVT had higher rates of intensive care unit admission, mechanical ventilation, prolonged hospitalization (median 24 vs. 8 days; P < 0.001), and in-hospital mortality (37.7% vs. 11.1%; P < 0.001). Pulmonary embolism was more common among patients with DVT (15.9% vs. 1.2%; P < 0.001). Independent predictors of DVT included prior DVT (aOR = 18.3; 95% confidence interval [CI], 5.22-63.9), obesity (aOR = 3.21; 95% CI, 1.92-5.38), smoking (aOR 2.59; 95% CI, 1.26-5.34), and oxygen requirement (aOR = 4.86; 95% CI, 2.35-10.1). Most events were acute and predominantly involved the left lower extremity.
CONCLUSION: Although uncommon, DVT in hospitalized COVID-19 patients was associated with substantial morbidity and mortality. A prior history of venous thrombosis was the strongest predictor, identifying a high-risk subgroup. The occurrence of clinically significant DVT despite routine pharmacological prophylaxis supports the need for risk-adapted diagnostic strategies, including targeted use of venous Doppler ultrasound.