The prevalence of thromboembolic events among COVID-19 patients admitted to a single centre intensive care unit (ICU): an epidemiological study from a Malaysian population
Introduction Thromboembolic (TE) complications in COVID-19 patients are rising globally, contributing significantly to mortality, particularly in severe cases. However, their prevalence, characteristics, and impact on mortality in Malaysia remain unclear.Objectives This study aimed to determine the...
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Taylor & Francis Group
2025-12-01
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| Series: | Journal of Pharmaceutical Policy and Practice |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/20523211.2024.2449044 |
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| author | Nur Farhani Mansor Izzati Abdul Halim Zaki Lee Chew Kiok Eng Kar Seng Tharmini Ravi Mohan Pathmanathan Khang Wen Goh Long Chiau Ming Pakhrur Razi Hanis Hanum Zulkifly |
| author_facet | Nur Farhani Mansor Izzati Abdul Halim Zaki Lee Chew Kiok Eng Kar Seng Tharmini Ravi Mohan Pathmanathan Khang Wen Goh Long Chiau Ming Pakhrur Razi Hanis Hanum Zulkifly |
| author_sort | Nur Farhani Mansor |
| collection | DOAJ |
| description | Introduction Thromboembolic (TE) complications in COVID-19 patients are rising globally, contributing significantly to mortality, particularly in severe cases. However, their prevalence, characteristics, and impact on mortality in Malaysia remain unclear.Objectives This study aimed to determine the prevalence of thromboembolic (TE) events and associated mortality among COVID-19 patients admitted within a single centre intensive care unit (ICU). The proportions of patients with TE events who died, and factors associated with TE events were explored.Methods In this retrospective cohort study, patients with PCR confirmed SARS-CoV-2 virus and who received thromboprophylaxis within February 2020–2021 were included. TE event is a combination of venous [(deep vein thrombosis (DVT), pulmonary embolism (PE)] and arterial (myocardial infarction (MI), stroke) thromboembolism.Results Mean (SD) age 56.6 (13.7), 63.5% were male, 61.6% Malays, median (IQR) 7 (3–14) days of ICU stay, 64.2%, 53.2% and 20.9% had underlying hypertension, diabetes and obesity respectively. In total, 240 (44.9%) developed TE event. Significantly higher proportions of COVID-19 patients who developed complications of DVT (2.5% vs. 0.2%; p = 0.013), PE (47.5% vs 34.0%; p = 0.006), stroke (12.3% vs. 1.5; p<0.001) and MI (16.4% vs. 4.6%; p<0.001) died. Predictors of TE events were age [HR 1.01 (95% CI 1.00–1.02)], obesity [HR 1.98 (95% CI 1.51–2.6)], D-dimer [HR 1.01 (95% CI 1.00–1.01)], and duration of ICU stay [HR 0.98 (95% CI 0.97–0.99)].Conclusion In severely ill COVID-19 patients, TE complications were common, and patients with DVT, PE, stroke, or MI faced increased mortality, even with thromboprophylaxis. Age, obesity, elevated D-Dimer levels, and longer ICU stays were significant predictors of TE events. Considering these findings, a more aggressive approach, combining thromboprophylaxis with enhanced anti-inflammatory treatments, may be necessary for high-risk COVID-19 ICU patients to reduce TE events and mortality. |
| format | Article |
| id | doaj-art-c4a8cde1c915420ea79d2ed52d4ebad8 |
| institution | Kabale University |
| issn | 2052-3211 |
| language | English |
| publishDate | 2025-12-01 |
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| series | Journal of Pharmaceutical Policy and Practice |
| spelling | doaj-art-c4a8cde1c915420ea79d2ed52d4ebad82025-02-05T11:21:34ZengTaylor & Francis GroupJournal of Pharmaceutical Policy and Practice2052-32112025-12-0118110.1080/20523211.2024.2449044The prevalence of thromboembolic events among COVID-19 patients admitted to a single centre intensive care unit (ICU): an epidemiological study from a Malaysian populationNur Farhani Mansor0Izzati Abdul Halim Zaki1Lee Chew Kiok2Eng Kar Seng3Tharmini Ravi4Mohan Pathmanathan5Khang Wen Goh6Long Chiau Ming7Pakhrur Razi8Hanis Hanum Zulkifly9Pharmacy Department, Kuala Lumpur Hospital, Kuala Lumpur, MalaysiaFaculty of Pharmacy, Universiti Teknologi MARA, UiTM Kampus Puncak Alam, Puncak Alam, MalaysiaAnesthesiology and Intensive Care Department, Sungai Buloh Hospital, Sungai Buloh, MalaysiaAnesthesiology and Intensive Care Department, Sungai Buloh Hospital, Sungai Buloh, MalaysiaClinical Research Center, Sungai Buloh Hospital, Sungai Buloh, MalaysiaInstitute for Clinical Research, National Institutes of Health, Shah Alam, MalaysiaFaculty of Data Science and Information Technology, INTI International University, Nilai, MalaysiaSchool of Medical and Life Sciences, Sunway University, Sunway City, MalaysiaCenter of Disaster Monitoring and Earth Observation, Physics Department, Universitas Negeri Padang, Padang, IndonesiaFaculty of Pharmacy, Universiti Teknologi MARA, UiTM Kampus Puncak Alam, Puncak Alam, MalaysiaIntroduction Thromboembolic (TE) complications in COVID-19 patients are rising globally, contributing significantly to mortality, particularly in severe cases. However, their prevalence, characteristics, and impact on mortality in Malaysia remain unclear.Objectives This study aimed to determine the prevalence of thromboembolic (TE) events and associated mortality among COVID-19 patients admitted within a single centre intensive care unit (ICU). The proportions of patients with TE events who died, and factors associated with TE events were explored.Methods In this retrospective cohort study, patients with PCR confirmed SARS-CoV-2 virus and who received thromboprophylaxis within February 2020–2021 were included. TE event is a combination of venous [(deep vein thrombosis (DVT), pulmonary embolism (PE)] and arterial (myocardial infarction (MI), stroke) thromboembolism.Results Mean (SD) age 56.6 (13.7), 63.5% were male, 61.6% Malays, median (IQR) 7 (3–14) days of ICU stay, 64.2%, 53.2% and 20.9% had underlying hypertension, diabetes and obesity respectively. In total, 240 (44.9%) developed TE event. Significantly higher proportions of COVID-19 patients who developed complications of DVT (2.5% vs. 0.2%; p = 0.013), PE (47.5% vs 34.0%; p = 0.006), stroke (12.3% vs. 1.5; p<0.001) and MI (16.4% vs. 4.6%; p<0.001) died. Predictors of TE events were age [HR 1.01 (95% CI 1.00–1.02)], obesity [HR 1.98 (95% CI 1.51–2.6)], D-dimer [HR 1.01 (95% CI 1.00–1.01)], and duration of ICU stay [HR 0.98 (95% CI 0.97–0.99)].Conclusion In severely ill COVID-19 patients, TE complications were common, and patients with DVT, PE, stroke, or MI faced increased mortality, even with thromboprophylaxis. Age, obesity, elevated D-Dimer levels, and longer ICU stays were significant predictors of TE events. Considering these findings, a more aggressive approach, combining thromboprophylaxis with enhanced anti-inflammatory treatments, may be necessary for high-risk COVID-19 ICU patients to reduce TE events and mortality.https://www.tandfonline.com/doi/10.1080/20523211.2024.2449044COVID-19intensive care unitthromboembolic complicationsmortalityhuman and diseasechronic respiratory disease |
| spellingShingle | Nur Farhani Mansor Izzati Abdul Halim Zaki Lee Chew Kiok Eng Kar Seng Tharmini Ravi Mohan Pathmanathan Khang Wen Goh Long Chiau Ming Pakhrur Razi Hanis Hanum Zulkifly The prevalence of thromboembolic events among COVID-19 patients admitted to a single centre intensive care unit (ICU): an epidemiological study from a Malaysian population Journal of Pharmaceutical Policy and Practice COVID-19 intensive care unit thromboembolic complications mortality human and disease chronic respiratory disease |
| title | The prevalence of thromboembolic events among COVID-19 patients admitted to a single centre intensive care unit (ICU): an epidemiological study from a Malaysian population |
| title_full | The prevalence of thromboembolic events among COVID-19 patients admitted to a single centre intensive care unit (ICU): an epidemiological study from a Malaysian population |
| title_fullStr | The prevalence of thromboembolic events among COVID-19 patients admitted to a single centre intensive care unit (ICU): an epidemiological study from a Malaysian population |
| title_full_unstemmed | The prevalence of thromboembolic events among COVID-19 patients admitted to a single centre intensive care unit (ICU): an epidemiological study from a Malaysian population |
| title_short | The prevalence of thromboembolic events among COVID-19 patients admitted to a single centre intensive care unit (ICU): an epidemiological study from a Malaysian population |
| title_sort | prevalence of thromboembolic events among covid 19 patients admitted to a single centre intensive care unit icu an epidemiological study from a malaysian population |
| topic | COVID-19 intensive care unit thromboembolic complications mortality human and disease chronic respiratory disease |
| url | https://www.tandfonline.com/doi/10.1080/20523211.2024.2449044 |
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