Increased incidence of symptomatic venous thrombosis associated with peripherally inserted central catheter in COVID-19 patients

Abstract

Introduction: The identification of catheter-associated symptomatic thrombosis in COVID-19 patients has not received sufficient attention. This study compared the incidence of peripherally inserted central catheter-associated symptomatic venous thrombosis (PICC-ASVT) in COVID-19 and non-COVID-19 patients. Materials and Methods: This was a historical cohort of non-COVID-19 patients treated from April 2018 to December 2019 and a retrospective cohort of COVID-19 patients treated from April 2020 to December 2021. A positive PICC-ASVT case was defined based on clinical manifestations of obstruction of intravenous solution flow confirmed by ultrasound. The incidence of PICC-ASVT was based on the total number of PICCs with venous thrombosis divided by the total number of PICCs placed. Results: COVID-19 patients had a higher incidence of PICC-ASVT: 38 of 617 cases had an incidence of 6.2%, while an incidence of 2.03% was found in 12 of 592 non-COVID-19 patients. The association of risk of PICC-ASVT in COVID-19 patients was up to sixfold (OR 3.1, 95% CI, 1.6–6.1). The most common area of hospital admission was the intensive care unit (ICU) in patients with PICC-ASVT in 24 (63.2%) of 38 cases, followed by the intermediate care unit (IMCU) in 11 cases (28.9%) (p < 0.001). No PICC-ASVT cases were found in the ward or the respiratory therapy unit (RTU). Conclusion: This study highlights the increased incidence of PICC-ASVT in COVID-19 patients. Thrombosis was associated with hospitalizations in the ICU and IMCU.