Thromboembolic complications during SARS-CoV-2 infection in the elderly

Abstract

Introduction: Classified as a pandemic by the WHO on March 11, 2020, infection with COVID-19 represents a real medical challenge. It is considered as a systemic disease with a pro-thrombotic state, at the origin of thromboembolic events (TEE). The aim of the present study is to determine the clinical and therapeutic particularities and evolution of TEE during infection by SARS-CoV-2 in elderly subjects. Methods: This was a retrospective and descriptive study including 150 patients, aged 65 and over, hospitalized in the COVID-19 unit during the period from January to March 2021. Results: Thirty four patients developed thromboembolic complications. The average age of our patients was 77.94 ± 7.198 years. The sex ratio (M/F) was 2.4. Comorbidities were noted in 82.4% of patients, dominated by arterial hypertension (61.8%) and diabetes (38.2%). The symptomatology was dominated by cough and acute dyspnea. Signs of acute respiratory failure were noted in 85.3% of cases. Venous thromboembolic complications were observed in 85.3% of patients represented by pulmonary embolism in all cases. Arterial thromboembolic complications were noted in 14.7% of patients represented by thoracic (60%) and abdominal (40%) thromboembolic events. The use of mechanical ventilation was necessary in 8.8% of patients. Low molecular weight heparin was prescribed in 94.1% of patients and unfractionated heparin in 5.9% of patients with chronic renal failure. Death occurred in 70.6% of patients. Conclusion: SARS-CoV-2 infection is a polymorphic disease and responsible for several TEE. In the absence of effective treatment, prevention of thrombosis is necessary to improve the prognosis.