MORTALIDAD DE LOS PACIENTES COVID-19 CON COMPLICACIONES TROMBÓTICAS VASCULARES

RESUMEN Objetivo: Presentar nuestra experiencia y analizar la supervivencia de los pacientes hospitalizados con COVID-19 y que presentaron algun proceso trombotico vascular Material y Metodos: Se incluyeron todos los pacientes consecutivos COVID-19 que fueron atendidos durante los meses de marzo-abril 2020 en nuestra institucion Se incluyeron pacientes sintomaticos con trombosis venosa profunda (TVP), tromboembolia pulmonar (TEP), ictus isquemico y trombosis arterial periferica (TAP) confirmados objetivamente Se analizaron las curvas de supervivencia de todos los grupos mediante Kaplan-Meier, test de Log Rank, y regresion de Cox Resultados: Durante el periodo pandemico del 1-marzo al 30-abril, se atendieron 2943 pacientes COVID-19 en nuestro centro 106 pacientes presentaron algun proceso trombotico vascular sintomatico: 13 pacientes tuvieron TAP, 15 ictus, 20 TVP y 58 TEP 11 pacientes mostraron trombosis vasculares multiples Aunque la edad media fue de 65 anos, fueron de edad mas avanzada los que mostraron trombosis arteriales que procesos tromboembolicos venosos El 67 92% fueron hombres En total, 25 pacientes murieron durante su ingreso hospitalario (23 58%), existiendo diferencias entre grupos, siendo mas comun en pacientes con TAP (9 pacientes de 13), e ictus isquemico (8 pacientes de 15), que en los de TVP (1 paciente de 20) o TEP (7 pacientes de 58) Conclusiones: El riesgo tromboembolico venoso en estos pacientes es mayor que el arterial, pero la trombosis arterial cuando acontece estuvo asociada a altas tasas de mortalidad La supervivencia fue mejor en los pacientes con TVP y TEP que en los pacientes con ictus isquemico o trombosis arterial periferica ABSTRACT Purpose: To analyze the survival of patients hospitalized with COVID-19 and who presented some vascular thrombotic complication Material and Methods: All consecutive patients with COVID-19 who were treated during the months of March and April 2020 at our institution were included All patients were symptomatic and the thrombotic event objectively confirmed Patients with deep vein thrombosis (DVT), pulmonary embolism (PE), ischemic stroke, and peripheral arterial thrombosis (PAT) were included Survival curves for all groups were analyzed using Kaplan-Meier with Log Rank test, and Cox regression Results: During the pandemic period from March-1 to April-30, 2943 patients were treated with confirmed COVID-19 in our center 106 patients showed some symptomatic vascular thrombosis: 13 patients had PAT, 15 ischemic stroke, 20 DVT and 58 PE 11 patients presented multiple vascular thrombosis Although the mean age was 65 years, there were differences between groups being older those patients with arterial thrombosis A 67 92% were men In total, 25 patients died during their hospital admission (23 58%), with differences between groups, being more common in patients with PAT (9 patients out of 13) and ischemic stroke (8 patients out of 15), than in those with DVT (1 patient out of 20) or PE (7 patients out of 58) Conclusions: The venous thromboembolic risk in these patients is greater than the arterial, but arterial thrombosis when it occurs was associated with high mortality rates Survival was better in patients with DVT and PE than in patients with ischemic stroke or PAT