Characterization of the thromboembolic risk in COVID-19

Abstract

Infection by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is called coronavirus disease 2019 (COVID-19). In advanced stages, the host's inflammatory immune response becomes dysregulated, resulting in the so-called "cytokine storm" and leading to the activation of coagulation mechanisms. As a result, the phenomenon of immunothrombosis is installed. Coagulation changes caused by SARS-CoV-2 infection form the COVID-19-associated coagulopathy (CAC). Blood tests and histopathological analyses suggest that the risk of thromboembolic events is greater among patients with COVID-19 than among those affected by other types of severe acute respiratory syndromes (SARS). In this context, identifying the pattern of coagulation markers and vascular involvement in a representative cohort of patients with COVID-19 will allow for early detection of cases with a higher risk of thromboembolic events and a reduction in mortality rates. The main goal of this study is to evaluate the frequency of these events in patients hospitalized due to COVID-19 and to compare it with the frequency of these events in other SARS that require hospitalization. We will select the first 100 patients with a positive RT-PCR result for COVID-19 and the first 100 patients with SRAG and a negative RT-PCR result for COVID-19, of both sexes and aged 18 years or older, that were admitted to the Hospital de Clínicas - UNICAMP from March 10th to July 31st, 2020. The clinical parameters to be evaluated will be divided into: i) baseline characteristics of patients; ii) symptoms; iii) laboratory characteristics; ix) drug treatment during hospitalization; and x) vascular complications. The patients' baseline characteristics will be subjected to descriptive analysis. The absolute risk of thromboembolic events and the associated risk factors in the two patient groups will be assessed by calculating the number of total events divided by the total people-time and by logistic regression analyses, respectively. At the end of the study, we expect to confirm the hypothesis that patients hospitalized with COVID-19 have higher risk of thromboembolic events compared to patients with other SARS that require hospitalization. (AU)