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Thrombo-inflammatory response in hospitalized patients with COVID-19; a single institution experience.

BACKGROUND: Severe COVID-19 causes acute inflammation which is complicated by venous thromboembolic events (VTE). However, it is unclear if VTE risk has evolved over time since the COVID-19 outbreak.

AIMS: To determine markers of thrombo-inflammation and rates of symptomatic VTE in patients hospitalized for COVID-19 in a metropolitan hospital in Sydney, Australia.

METHODS: A retrospective, single-centre, cohort study was performed by reviewing electronic medical records of consecutive patients admitted to Royal Prince Alfred hospital between March 2020 and September 2021. This period included 3 waves of COVID-19 outbreaks in Australia with the ancestral, alpha and delta variants. Standard coagulation assays and inflammatory markers were recorded over 4 weeks.

RESULTS: A total of 205 patients were consecutively admitted during the study period. Activated partial thromboplastin time, neutrophil count, and C-reactive protein (CRP) were significantly increased in patients hospitalized in the intensive care unit (ICU) compared with non-ICU patients. The use of anti-inflammatory medication increased in 2021 compared with 2020. The mortality rate was 7.3% in our cohort. Ninety-four % of patients received anticoagulation with 6.3% of patients developing VTE.

CONCLUSION: We observed lower rates of VTE compared to the internationally reported for the same period. We conclude that in the setting of controlled hospital admission rate and standard anticoagulation guidelines, COVID-19 resulted in similar thrombo-inflammatory response and VTE rates over the first 1.5 years of the pandemic. This article is protected by copyright. All rights reserved.

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