North Texas GME Research Forum 2024

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Division

North Texas

Hospital

Medical City Arlington

Specialty

Internal Medicine

Document Type

Poster

Publication Date

2024

Keywords

COVID-19, SARS-CoV-2, ischemia

Disciplines

Internal Medicine | Medicine and Health Sciences | Pathological Conditions, Signs and Symptoms | Virus Diseases

Abstract

Introduction: Patient with COVID-19 are more likely to have thrombotic events, including deep vein thrombosis (DVT), pulmonary embolism (PE), and disseminated intravascular coagulation (DIC). There have been many case reports of patient with acute mesenteric ischemia (AMI) in the setting of COVID-19. Incidences of AMI occur in about 0.1% of acute hospital admissions. Short term mortality from AMI range from 26-86%. Therefore, early diagnosis and treatment are essential, yet diagnosis is difficult and AMI can often go unrecognized as a cause of death. This study attempted to establish the risk of patients with COVID-19 having acute mesenteric ischemia and compare it to the risk of patients without COVID-19 having acute mesenteric ischemia. Methods: This was a retrospective cohort study that was done with secondary retrospective analysis of existing, de-identified data. Patients included were those who were hospitalized at a North Texas HCA Healthcare affiliated hospital from March 2020 to October 2021. Patients were included from the database using ICD-10 codes. The main variable looked at in this study was patients with COVID-19 with patients without COVID-19 as the control. The main outcome measured was AMI. Results: The total number of patients obtained from data query was 168,824 from March 2020 to October 2021 (N = 168,824). COVID-19 status was 22,095 (13.09%) positive and 146,729 (86.91%) negative. There was a total of 41 patients with AMI (0.02%). Three patients (0.01%) in the COVID-19 positive cohort had AMI while 38 patients (0.03%) in the COVID-19 negative cohort had AMI (RR 0.5243, 95% CI 0.1619 to 1.6983, p = 0.2816). Conclusion: The results of this study showed that there is no statistically significant increased or decreased risk of AMI in COVID-19 positive patients. There were several limitations in this study. One limitation was a low number of AMI in COVID-19 positive cohort limiting the power of the study. Another limitation could be the underdiagnosis or incorrect coding of AMI. Given that there are some significant limitations to this study, future studies to compare the risk of AMI in COVID-19 patients can be done on a population that more reflects the general population. There will also need to be attention given to the number of patients in each cohort to provide enough power for the study given the expected incidence of AMI.

Original Publisher

HCA Healthcare Graduate Medical Education

Acute Mesenteric Ischemia in Patients with COVID-19

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