PB0891 - Exploring Immune-Mediated Thrombosis in COVID-19: Insights from a Single-centre Study

Monday, June 24, 2024

13:45 – 14:45 ICT

Room: Exhibition Hall

Presenting Author(s)

Gilbert Wilfred, Bachelor in Medicine and Surgery, Master in Medicine (Internal Medicine), Fellowship in Clinical Haematology

Hematologist
Hematology Unit, Queen Elizabeth Hospital Kota Kinabalu Sabah Malaysia
Kota Kinabalu, Sabah, Malaysia

Co-Author(s)

YC

Yen Lik Chia

Medical Officer
Department of Medicine, Queen Elizabeth Hospital Kota Kinabalu Sabah Malaysia
Kota Kinabalu, Sabah, Malaysia
MC

Min Huang Chua

Medical Officer
Department of Medicine, Queen Elizabeth Hospital Kota Kinabalu Sabah Malaysia
Kota Kinabalu, Sabah, Malaysia
MT

Melody Tsen

Medical Officer
Department of Medicine, Queen Elizabeth Hospital Kota Kinabalu Sabah Malaysia
Kota Kinabalu, Sabah, Malaysia
HL

Hong Wei Lee

Medical Officer
Department of Medicine, Queen Elizabeth Hospital Kota Kinabalu Sabah Malaysia
Kota Kinabalu, Sabah, Malaysia
HC

Heng Chang Choo

Physician
Hematology Unit, Queen Elizabeth Hospital Kota Kinabalu Sabah Malaysia
Kota Kinabalu, Sabah, Malaysia
NB

Nury Namerra Buhari

Medical Officer
Department of Radiology, Queen Elizabeth Hospital Kota Kinabalu Sabah Malaysia
Kota Kinabalu, Sabah, Malaysia
KR

Khaiteri R

Hematologist
Hematology Unit, Queen Elizabeth Hospital Kota Kinabalu Sabah Malaysia
Kota Kinabalu, Sabah, Malaysia
LW

Lily WLL

Consultant Hematologist
Hematology Unit, Queen Elizabeth Hospital Kota Kinabalu Sabah Malaysia
Kota Kinabalu, Sabah, Malaysia

Background: COVID-19 infection predisposes individuals to thrombotic events through inflammation, endothelial cell and platelet activation, and hypercoagulability. Heterogenous data indicate varied incidences of COVID-19-associated coagulopathy. Limited clinical data is available from Asians, recognized for their presumed low thrombogenic phenotype.

Aims: This study aims to evaluate the frequency of thrombosis in COVID-19 patients and to establish correlation between inflammatory markers and the occurrence of thrombotic events.

Methods: Data extracted from medical records and Queen Elizabeth Hospital database. Patients with COVID-19 infection and suspected thrombotic events between March 1, 2020, and March 31, 2021, were included. Demographic details, clinical characteristics and relevant investigations were collected and analyzed using Statistical Package for Social Sciences (SPSS) version 25.0.

Results: A total of 84 patients were enrolled in this study with a mean age of 53.231.82 years. Fifty seven percent were male, and majority of the cases were admitted to isolation ward (69.5%) with at least stage 4 disease (94%). Based on our cohort, the incidence of COVID-19 associated thrombosis is 1%. Despite venous thromboembolism (VTE) prophylaxis, 11.9% (n=10) developed pulmonary embolism, primarily in the intensive care unit (ICU) setting (70%) with peak oxygen requirement of 10L/min using facemask with reservoir. Common laboratory findings among the patients with pulmonary embolism included elevated D-dimer (n=9), normal platelet count (n=9), and increased CRP (n=6). Notably, lymphopenia (n=3) and moderate to severe neutrophil-lymphocyte ratio (n=4) were infrequently observed. A smaller proportion of the cases experienced arterial thrombosis, specifically stroke (n=4), with all stroke patients had lymphopenia, anemia, and normal D-dimer.

Conclusion(s): In this study, thrombotic events were generally low, even within the context of COVID-19 infection. A larger sample size and extended study duration may enhance precision in correlating inflammatory markers with thrombosis.