Clinical and Applied Thrombosis/Hemostasis (Aug 2022)

Real-World Analysis of Thromboembolic Events and Mortality of COVID-19 Outpatients in the United States

  • W. Frank Peacock MD, FACEP, FACC, FESC,
  • James M. Crawford MD, PhD,
  • Yen-Wen (Cindy) Chen PhD,
  • Veronica Ashton MPH,
  • Alicia K. Campbell PharmD,
  • Dejan Milentijevic PhD, MBA,
  • Alex C. Spyropoulos MD, FACP, FCCP, FRCPC

DOI
https://doi.org/10.1177/10760296221120421
Journal volume & issue
Vol. 28

Abstract

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Limited data are available on thromboembolic events (TEEs) and mortality in outpatients with coronavirus disease 2019 (COVID-19). This retrospective, observational cohort study identified non-hospitalized COVID-19 outpatients (01/21/2020-01/07/2021) using de-identified Optum ® COVID-19 Electronic Health Records data. Patient characteristics, occurrence of TEEs, all-cause mortality, and anticoagulant or thrombolytic medication use were evaluated. Of 1,246,067 patients with COVID-19 diagnosis, 141 471 met entry criteria. Mean (standard deviation [SD]) age was 46.1 (17.2) years, 56.8% were female, 72.9% Caucasian, 11.2% African American, and 11.1% Hispanic. Comorbidity burden was low (mean [SD] Quan-Charlson comorbidity index score of 0.43 [1.10]); however, of those with body mass index data, half were obese. During the follow-up period, a TEE occurred in 1.4%, with the proportion of patients with ischemic stroke, myocardial infarction, deep vein thrombosis, and pulmonary embolism being similar (approximately 0.4% each). All-cause mortality was 0.7%. Medications included corticosteroids (13.7%), anticoagulants (4.9%), and antiplatelets (2.9%). Overall, in this large cohort analysis, certain demographic and clinical characteristics of patients who experienced TEEs were identified and may help guide management decisions and future clinical trials for COVID-19 outpatients.