Thrombotic complications in critically ill patients with coronavirus infections: A comparative study of MERS and COVID-19

Coronaviruses include coronavirus disease 2019 (COVID-19) and Middle East respiratory syndrome (MERS). These viruses cause respiratory infections in humans and share several overlapping structural, pathological, and genetic features. This study compared arterial and venous thrombotic events in critically ill patients with COVID-19 and MERS. This study was conducted in the intensive care units of 2 hospitals in Saudi Arabia. Polymerase chain reaction-positive patients who were diagnosed with COVID-19 between February and July 2020 and polymerase chain reaction-positive patients with MERS from March to May 2014 were included. The data were analyzed via SAS version 9.4 (SAS Institute, Cary, NC). This study included 294 patients, 234 (79.6%) of whom had COVID-19, and 60 (20.4%) had MERS. Overall, the rate of composite thrombotic events was 44 (14.97%) in both groups, comprising 25 patients with venous thromboembolism (23 patients with COVID-19 and 2 in the MERS group) and 19 with arterial thrombotic episodes (14 patients with COVID-19 and 5 in the MERS group). Bronchial asthma was significantly associated with thrombosis (P = .02). Enoxaparin was the most frequently prescribed thromboprophylaxis 189 (64.5%). There was no significant difference in venous thromboembolism (P = .10), bleeding complications (P = .53), or mortality (P = .08) between the COVID-19 and MERS patients. We found a similar rate of composite thrombotic events in critically ill patients with COVID-19 and MERS. While the thrombotic tendency of patients with COVID-19 was previously known, we uniquely identified the role of MERS in both arterial and venous thrombosis.