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337. SARS-CoV-2 Viral Load Does Not Predict Incident Venous Thromboembolism in COVID-19

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Affiliations

  • 1. Uniformed Services University of the Health Sciences , Bethesda, Maryland
      Authors
    • Pollett S 1
    • Wier B 1
    • Utz G 1
    • Scher A 1
    • Rusiecki J 1
    • Simons M 1
    • Tribble D 1
    (7 authors)
  • 2. Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD and Henry M. Jackson Foundation, Bethesda , MD, Bethesda, Maryland
      Authors
    • Richard S 2
    (1 author)
  • 3. United States Air Force School of Aerospace Medicine , Wright-Patterson AFB, Ohio
      Authors
    • Fries A 3
    (1 author)
  • 4. Naval Medical Center San Diego, San Diego, CA and Infectious Disease Clinical Research Program, Bethesda, MD , San DIego, California
      Authors
    • Maves R 4
    • Maves R 4
    (2 authors)
  • 5. IDCRP, HJF , and NMCP, Bethesda, Maryland
      Authors
    • Lalani T 5
    (1 author)
    • Show all (18)

ORCIDs linked to this article

Open Forum Infectious Diseases, 01 Nov 2021, 8(Suppl 1):S273-S273
PMCID: PMC8690504

This article is in the Europe PMC Open access subset. Refer to the copyright information in the article for licensing details.
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Abstract 

No abstract provided.

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Open Forum Infect Dis. 2021 Nov; 8(Suppl 1): S273.
Published online 2021 Dec 4. https://doi.org/10.1093/ofid/ofab466.538
PMCID: PMC8690504

337. SARS-CoV-2 Viral Load Does Not Predict Incident Venous Thromboembolism in COVID-19

Simon Pollett, MBBS,1 Benjamin Wier, DVM,1 Stephanie A Richard, PhD, MHS,2 Anthony C Fries, PhD,3 Ryan C Maves, MD,4 Ryan C Maves, MD,4 Gregory Utz, MD,1 Tahaniyat Lalani, MBBS,5 Rupal Mody, MD,6 Anuradha Ganesan, MBBS, MPH,7 Rhonda E Colombo, MD, MHS,8 Chris Colombo, MD,9 David A Lindholm, MD,10 David A Lindholm, MD,10 Cristian Madar, MD,11 Sharon Chi, MD,12 Nikhil Huprikar, MD,13 Derek Larson, MD,14 Samantha Bazan, DNP, MS,15 Ann Scher, PhD,1 Jennifer Rusiecki, PhD,1 Celia Byrne, PhD,16 Katrin Mende, PhD,17 Mark P Simons, Ph.D., MSPH,1 David Tribble, M.D., DrPH,1 Brian Agan, MD,18 and Timothy Burgess, MD, MPH12
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Abstract

Background

The risk factors of venous thromboembolism (VTE) in COVID-19 warrant further study. We leveraged a cohort in the Military Health System (MHS) to identify clinical and virological predictors of incident deep venous thrombosis (DVT), pulmonary embolism (PE), and other VTE within 90-days after COVID-19 onset.

Methods

PCR or serologically-confirmed SARS-CoV-2 infected MHS beneficiaries were enrolled via nine military treatment facilities (MTF) through April 2021. Case characteristics were derived from interview and review of the electronic medical record (EMR) through one-year follow-up in outpatients and inpatients. qPCR was performed on upper respiratory swab specimens collected post-enrollment to estimate SARS-CoV-2 viral load. The frequency of incident DVT, PE, or other VTE by 90-days post-COVID-19 onset were ascertained by ICD-10 code. Correlates of 90-day VTE were determined through multivariate logistic regression, including age and sampling-time-adjusted log10-SARS-CoV-2 GE/reaction as a priori predictors in addition to other demographic and clinical covariates which were selected through stepwise regression.

Results

1473 participants with SARS-CoV-2 infection were enrolled through April 2021. 21% of study participants were inpatients; the mean age was 41 years (SD = 17.0 years). The median Charlson Comorbidity Index score was 0 (IQR = 0 - 1, range = 0 - 13). 27 (1.8%) had a prior history of VTE. Mean maximum viral load observed was 1.65 x 107 genome equivalents/reaction. 36 (2.4%) of all SARS-CoV-2 cases (including inpatients and outpatients), 29 (9.5%) of COVID-19 inpatients, and 7 (0.6%) of outpatients received an ICD-10 diagnosis of any VTE within 90 days after COVID-19 onset. Logistic regression identified hospitalization (aOR = 11.1, p = 0.003) and prior VTE (aOR = 6.2 , p = 0.009) as independent predictors of VTE within 90 days of symptom onset. Neither age (aOR = 1.0, p = 0.50), other demographic covariates, other comorbidities, nor SARS-CoV-2 viral load (aOR = 1.1, p = 0.60) were associated with 90-day VTE.

Conclusion

VTE was relatively frequent in this MHS cohort. SARS-CoV-2 viral load did not increase the odds of 90-day VTE. Rather, being hospitalized for SARS-CoV-2 and prior VTE history remained the strongest predictors of this complication.

Disclosures

Simon Pollett, MBBS, Astra Zeneca (Other Financial or Material Support, HJF, in support of USU IDCRP, funded under a CRADA to augment the conduct of an unrelated Phase III COVID-19 vaccine trial sponsored by AstraZeneca as part of USG response (unrelated work)) Ryan C. Maves, MD, EMD Serono (Advisor or Review Panel member)Heron Therapeutics (Advisor or Review Panel member) David A. Lindholm, MD, American Board of Internal Medicine (Individual(s) Involved: Self): Member of Auxiliary R&D Infectious Disease Item-Writer Task Force. No financial support received. No exam questions will be disclosed ., Other Financial or Material Support David Tribble, M.D., DrPH, Astra Zeneca (Other Financial or Material Support, HJF, in support of USU IDCRP, funded under a CRADA to augment the conduct of an unrelated Phase III COVID-19 vaccine trial sponsored by AstraZeneca as part of USG response (unrelated work))