Imperial College Healthcare NHS Trust

CQC Registered Health or/and Social Care provider

Alun Davies

DISCOVERNOW10

Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is a novel coronavirus that causes Corona Virus Disease -19 (COVID-19). As of 20/04/2020, there have been over 2.3 million cases globally causing 157,970 deaths, of which over 120,000 cases have been in the UK leading to over 16,000 deaths. Venous thromboembolism (VTE) describes blood clots (or thrombosis) in the circulatory system. VTE includes both deep vein thrombosis (DVT) which describes clots in the legs, and pulmonary embolism (PE) which describes clots in circulation of the lungs. The annual mortality of Hospital acquired thrombosis (HAT) is estimated to be approximately 24,000- 32,000 excess deaths per year (1). Although much is still unknown about COVID-19, there is evidence that the rate of venous thrombosis in these patients is elevated, although the data is limited. Recent preliminary results from a cross-sectional prevalence study in Lombardy, Italy, has identified that of 108 COVID-19 patients, 23% of intubated ITU patients and 8% of patients spontaneously ventilating developed DVT; 19% developed PE (2). On the 24th April 2020, the British Thoracic Society issued guidance on Venous Thromboembolic Disease in patients with COVID-19, the BTS made recommendations for anticoagulation in COVID-19 patients along with available evidence summaries (3). Objectives: To estimate the proportion of patients with COVID-19 who develop VTE within 90 days of hospitalization with COVID-19 and to identify possible risk factors for developing VTE in the COVID-19 cohort of patients. Primary End Point: • Identify the number of patients recorded as having developed VTE within 90 days following COVID-19 hospitalization. Secondary End Points: • Evaluate risk factors associated with the development of VTE including: Sociodemographic factors (age, gender, weight, ethnicity), Biochemical factors (abnormal blood results including d-dimer), COVID 19 factors (hospitalization, length of hospitalization, need for intensive care) • Evaluate the management used in COVID-19 patients with VTE e.g. type of anticoagulation and duration • Estimate overall all-cause and VTE related mortality of COVID-19 patients with VTE • Evaluate side effects of treatment e.g. minor and major bleeding events whilst on anticoagulation.

22/05/2020