Thrombotic and haemorrhagic complications in critically ill patients with COVID-19: a multicentre observational study
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RESEARCH
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Thrombotic and haemorrhagic complications in critically ill patients with COVID-19: a multicentre observational study Akshay Shah1,2*† , Killian Donovan2†, Anna McHugh3, Manish Pandey4, Louise Aaron2, Charlotte A. Bradbury5, Simon J. Stanworth1,6, Raza Alikhan7, Stephen Von Kier8, Keith Maher8, Nicola Curry6,9, Susan Shapiro6,9, Matthew J. Rowland2,10, Matt Thomas3, Richard Mason3, Matthew Holland3, Tom Holmes4, Michael Ware4, Stefan Gurney11† and Stuart R. McKechnie2†
Abstract Background: Optimal prophylactic and therapeutic management of thromboembolic disease in patients with COVID19 remains a major challenge for clinicians. The aim of this study was to define the incidence of thrombotic and haemorrhagic complications in critically ill patients with COVID-19. In addition, we sought to characterise coagulation profiles using thromboelastography and explore possible biological differences between patients with and without thrombotic complications. Methods: We conducted a multicentre retrospective observational study evaluating all the COVID-19 patients received in four intensive care units (ICUs) of four tertiary hospitals in the UK between March 15, 2020, and May 05, 2020. Clinical characteristics, laboratory data, thromboelastography profiles and clinical outcome data were evaluated between patients with and without thrombotic complications. (Continued on next page)
* Correspondence: [email protected] † Akshay Shah, Killian Donovan, Stefan Gurney and Stuart R. McKechnie contributed equally to this work. 1 Radcliffe Department of Medicine, Level 4 Academic Block, University of Oxford, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK 2 Adult Intensive Care Unit, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
Shah et al. Critical Care
(2020) 24:561
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