Incidence of symptomatic venous thromboembolism following hospitalization for coronavirus disease 2019: prospective results from a multi-center study

Background Thrombosis and pulmonary embolism appear to be major causes of mortality in hospitalized coronavirus disease 2019 (COVID-19) patients However, few studies have focused on the incidence of venous thromboembolism (VTE) after hospitalization for COVID-19 Methods In this multi-center study, we followed 1529 COVID-19 patients for at least 45 days after hospital discharge, who underwent routine telephone follow-up In case of signs or symptoms of pulmonary embolism (PE) or deep vein thrombosis (DVT), they were invited for an in-hospital visit with a pulmonologist The primary outcome was symptomatic VTE within 45 days of hospital discharge Results Of 1529 COVID-19 patients discharged from hospital, a total of 228 (14 9%) reported potential signs or symptoms of PE or DVT and were seen for an in-hospital visit Of these, 13 and 12 received Doppler ultrasounds or pulmonary CT angiography, respectively, of whom only one patient was diagnosed with symptomatic PE Of 51 (3 3%) patients who died after discharge, two deaths were attributed to VTE corresponding to a 45-day cumulative rate of symptomatic VTE of 0 2% (95%CI 0 1%-0 6%;n=3) There was no evidence of acute respiratory distress syndrome (ARDS) in these patients Other deaths after hospital discharge included myocardial infarction (n=13), heart failure (n=9), and stroke (n=9) Conclusions We did not observe a high rate of symptomatic VTE in COVID-19 patients after hospital discharge Routine extended thromboprophylaxis after hospitalization for COVID-19 may not have a net clinical benefit Randomized trials may be warranted