Abstract
【Background】 Coronavirus disease 2019 (COVID-19) has been reported to be associated with a high incidence of thrombosis including venous thromboembolism (VTE). 【Method】 This study was a retrospective study enrolling consecutive hospitalized patients with COVID-19 in Yokohama Minami Kyosai Hospital from April 11th, 2021, to September 30th, 2021, including fourth and fifth waves of the COVID-19 infections in Japan. During this term, we took measures to prevent arterial and venous thrombotic complications including a high prevalence of VTE for COVID-19 patients based on Clinical Guidance of Prevention of Venous Thromboembolism in COVID-19 (Version 2.0) by a collaborative effort with the Japanese Society of Phlebology, et al. 【Result】 Among 94 patients with COVID-19, 75 (79.8%) received pharmacological thromboprophylaxis. The proportion of pharmacological thromboprophylaxis increased according to the severity of the COVID-19 in 11.1% with mild and moderate I COVID-19, 94.9% with moderate II COVID-19, and 100% with severe COVID-19. Among the patients with anticoagulants, 98.7% received unfractionated heparin (UFH) of a prophylactic dose, and 1.3% received Warfarin. During the hospitalization, 2 patients (2.1%) developed thrombosis, one severe COVID-19 patient developed non-massive pulmonary embolism with the left peroneal vein DVT, and one moderate II COVID-19 patient developed aortic thrombosis. Major bleeding complication occurred in 2 patients (2.1%), both received UFH of a prophylactic dose. The bleeding site were retroperitoneal in one patient and gastrointestinal in one patient. Five patients (5.5%) died, and all of them were due to respiratory failure from COVID-19 pneumonia. 【Conclusion】 In this study, the results of our study population with current guidance for thrombosis prevention support that the overall incidence of thrombosis was substantially low with an increased incidence according to the severity of the COVID-19, however the risk of bleeding adverse events seemed to be high with anticoagulation therapy in Japan.
