tetano
Editor, Senior Moderator
Biomed Res Int
. 2020 Nov 6;2020:9126148.
doi: 10.1155/2020/9126148. eCollection 2020.
Predicting Venous Thromboembolic Events in Patients with Coronavirus Disease 2019 Requiring Hospitalization: an Observational Retrospective Study by the COVIDIC Initiative in a Swiss University Hospital
Eleftheria Kampouri[SUP] 1 [/SUP], Paraskevas Filippidis[SUP] 1 [/SUP], Benjamin Viala[SUP] 1 [/SUP], Marie M?an[SUP] 2 [/SUP], Olivier Pantet[SUP] 3 [/SUP], Florian Desgranges[SUP] 1 [/SUP], Jonathan Tschopp[SUP] 1 [/SUP], Jean Regina[SUP] 1 [/SUP], Eleftherios Karachalias[SUP] 4 [/SUP], Christophe Bianchi[SUP] 2 [/SUP], Maxime G Zermatten[SUP] 5 [/SUP], Katia Jaton[SUP] 6 [/SUP], Salah Dine Qanadli[SUP] 7 [/SUP], Pierre-Alexandre Bart[SUP] 2 [/SUP], Jean-Luc Pagani[SUP] 3 [/SUP], Benoit Guery[SUP] 1 [/SUP], Lorenzo Alberio[SUP] 5 [/SUP], Matthaios Papadimitriou-Olivgeris[SUP] 1 8 [/SUP], RegCOVID Research Group[SUP] 1 [/SUP]
Affiliations
Abstract
Background: Coronavirus disease 2019 (COVID-19) can result in profound changes in blood coagulation. The aim of the study was to determine the incidence and predictors of venous thromboembolic events (VTE) among patients with COVID-19 requiring hospital admission. Subjects and Methods. We performed a retrospective study at the Lausanne University Hospital with patients admitted because of COVID-19 from February 28 to April 30, 2020.
Results: Among 443 patients with COVID-19, VTE was diagnosed in 41 patients (9.3%; 27 pulmonary embolisms, 12 deep vein thrombosis, one pulmonary embolism and deep vein thrombosis, one portal vein thrombosis). VTE was diagnosed already upon admission in 14 (34.1%) patients and 27 (65.9%) during hospital stay (18 in ICU and nine in wards outside the ICU). Multivariate analysis revealed D-dimer value > 3,120 ng/ml (P < 0.001; OR 15.8, 95% CI 4.7-52.9) and duration of 8 days or more from COVID-19 symptoms onset to presentation (P 0.020; OR 4.8, 95% CI 1.3-18.3) to be independently associated with VTE upon admission. D-dimer value ≥ 3,000 ng/l combined with a Wells score for PE ≥ 2 was highly specific (sensitivity 57.1%, specificity 91.6%) in detecting VTE upon admission. Development of VTE during hospitalization was independently associated with D-dimer value > 5,611 ng/ml (P < 0.001; OR 6.3, 95% CI 2.4-16.2) and mechanical ventilation (P < 0.001; OR 5.9, 95% CI 2.3-15.1).
Conclusions: VTE seems to be a common COVID-19 complication upon admission and during hospitalization, especially in ICU. The combination of Wells ≥ 2 score and D - dimer ≥ 3,000 ng/l is a good predictor of VTE at admission.
. 2020 Nov 6;2020:9126148.
doi: 10.1155/2020/9126148. eCollection 2020.
Predicting Venous Thromboembolic Events in Patients with Coronavirus Disease 2019 Requiring Hospitalization: an Observational Retrospective Study by the COVIDIC Initiative in a Swiss University Hospital
Eleftheria Kampouri[SUP] 1 [/SUP], Paraskevas Filippidis[SUP] 1 [/SUP], Benjamin Viala[SUP] 1 [/SUP], Marie M?an[SUP] 2 [/SUP], Olivier Pantet[SUP] 3 [/SUP], Florian Desgranges[SUP] 1 [/SUP], Jonathan Tschopp[SUP] 1 [/SUP], Jean Regina[SUP] 1 [/SUP], Eleftherios Karachalias[SUP] 4 [/SUP], Christophe Bianchi[SUP] 2 [/SUP], Maxime G Zermatten[SUP] 5 [/SUP], Katia Jaton[SUP] 6 [/SUP], Salah Dine Qanadli[SUP] 7 [/SUP], Pierre-Alexandre Bart[SUP] 2 [/SUP], Jean-Luc Pagani[SUP] 3 [/SUP], Benoit Guery[SUP] 1 [/SUP], Lorenzo Alberio[SUP] 5 [/SUP], Matthaios Papadimitriou-Olivgeris[SUP] 1 8 [/SUP], RegCOVID Research Group[SUP] 1 [/SUP]
Affiliations
- PMID: 33204727
- PMCID: PMC7656238
- DOI: 10.1155/2020/9126148
Abstract
Background: Coronavirus disease 2019 (COVID-19) can result in profound changes in blood coagulation. The aim of the study was to determine the incidence and predictors of venous thromboembolic events (VTE) among patients with COVID-19 requiring hospital admission. Subjects and Methods. We performed a retrospective study at the Lausanne University Hospital with patients admitted because of COVID-19 from February 28 to April 30, 2020.
Results: Among 443 patients with COVID-19, VTE was diagnosed in 41 patients (9.3%; 27 pulmonary embolisms, 12 deep vein thrombosis, one pulmonary embolism and deep vein thrombosis, one portal vein thrombosis). VTE was diagnosed already upon admission in 14 (34.1%) patients and 27 (65.9%) during hospital stay (18 in ICU and nine in wards outside the ICU). Multivariate analysis revealed D-dimer value > 3,120 ng/ml (P < 0.001; OR 15.8, 95% CI 4.7-52.9) and duration of 8 days or more from COVID-19 symptoms onset to presentation (P 0.020; OR 4.8, 95% CI 1.3-18.3) to be independently associated with VTE upon admission. D-dimer value ≥ 3,000 ng/l combined with a Wells score for PE ≥ 2 was highly specific (sensitivity 57.1%, specificity 91.6%) in detecting VTE upon admission. Development of VTE during hospitalization was independently associated with D-dimer value > 5,611 ng/ml (P < 0.001; OR 6.3, 95% CI 2.4-16.2) and mechanical ventilation (P < 0.001; OR 5.9, 95% CI 2.3-15.1).
Conclusions: VTE seems to be a common COVID-19 complication upon admission and during hospitalization, especially in ICU. The combination of Wells ≥ 2 score and D - dimer ≥ 3,000 ng/l is a good predictor of VTE at admission.