tetano
Editor, Senior Moderator
Medicine (Baltimore)
. 2021 Jan 8;100(1):e24002.
doi: 10.1097/MD.0000000000024002.
Pulmonary thromboembolism in coronavirus disease 2019 patients undergoing thromboprophylaxis
Simone Schiaffino[SUP] 1 [/SUP], Francesca Giacomazzi[SUP] 2 [/SUP], Anastassia Esseridou[SUP] 1 [/SUP], Andrea Cozzi[SUP] 3 [/SUP], Serena Carriero[SUP] 4 [/SUP], Daniela P Mazzaccaro[SUP] 5 [/SUP], Giovanni Nano[SUP] 5 [/SUP], Giovanni Di Leo[SUP] 1 [/SUP], Pietro Spagnolo[SUP] 1 [/SUP], Francesco Sardanelli[SUP] 1 3 [/SUP]
Affiliations
Abstract
We aimed to investigate the prevalence of pulmonary thromboembolism (PTE) and its association with clinical variables in a cohort of hospitalized coronavirus disease 2019 (COVID-19) patients receiving low-molecular-weight heparin (LMWH) at prophylactic dosage.In this retrospective observational study we included COVID-19 patients receiving prophylactic LMWH from admission but still referred for lower-limbs venous Doppler ultrasound (LL-US) and computed tomography pulmonary angiography (CTPA) for clinical PTE suspicion. A dedicated radiologist reviewed CTPA images to assess PTE presence/extension.From March 1 to April 30, 2020, 45 patients were included (34 men, median age 67 years, interquartile range [IQR] 60-76). Twenty-seven (60%) had PTE signs at CTPA, 17/27 (63%) with bilateral involvement, none with main branch PTE. In 33/45 patients (73%) patients LL-US was performed before CTPA, with 3 patients having superficial vein thrombosis (9%, none with CTPA-confirmed PTE) and 1 patient having deep vein thrombosis (3%, with CTPA-confirmed PTE). Thirty-three patients (73%) had at least one comorbidity, mainly hypertension (23/45, 51%) and cardiovascular disease (15/45, 33%). Before CTPA, 5 patients had high D-dimer (11.21 μg/mL, IQR 9.10-13.02), 19 high fibrinogen (550 mg/dL, IQR 476-590), 26 high interleukin-6 (79 pg/mL, IQR 31-282), and 11 high C-reactive protein (9.60 mg/dL, IQR 6.75-10.65), C-reactive protein being the only laboratory parameter significantly differing between patients with and without PTE (P = .002)High PTE incidence (60%) in COVID-19 hospitalized patients under prophylactic LMWH could substantiate further tailoring of anticoagulation therapy.
. 2021 Jan 8;100(1):e24002.
doi: 10.1097/MD.0000000000024002.
Pulmonary thromboembolism in coronavirus disease 2019 patients undergoing thromboprophylaxis
Simone Schiaffino[SUP] 1 [/SUP], Francesca Giacomazzi[SUP] 2 [/SUP], Anastassia Esseridou[SUP] 1 [/SUP], Andrea Cozzi[SUP] 3 [/SUP], Serena Carriero[SUP] 4 [/SUP], Daniela P Mazzaccaro[SUP] 5 [/SUP], Giovanni Nano[SUP] 5 [/SUP], Giovanni Di Leo[SUP] 1 [/SUP], Pietro Spagnolo[SUP] 1 [/SUP], Francesco Sardanelli[SUP] 1 3 [/SUP]
Affiliations
- PMID: 33429763
- DOI: 10.1097/MD.0000000000024002
Abstract
We aimed to investigate the prevalence of pulmonary thromboembolism (PTE) and its association with clinical variables in a cohort of hospitalized coronavirus disease 2019 (COVID-19) patients receiving low-molecular-weight heparin (LMWH) at prophylactic dosage.In this retrospective observational study we included COVID-19 patients receiving prophylactic LMWH from admission but still referred for lower-limbs venous Doppler ultrasound (LL-US) and computed tomography pulmonary angiography (CTPA) for clinical PTE suspicion. A dedicated radiologist reviewed CTPA images to assess PTE presence/extension.From March 1 to April 30, 2020, 45 patients were included (34 men, median age 67 years, interquartile range [IQR] 60-76). Twenty-seven (60%) had PTE signs at CTPA, 17/27 (63%) with bilateral involvement, none with main branch PTE. In 33/45 patients (73%) patients LL-US was performed before CTPA, with 3 patients having superficial vein thrombosis (9%, none with CTPA-confirmed PTE) and 1 patient having deep vein thrombosis (3%, with CTPA-confirmed PTE). Thirty-three patients (73%) had at least one comorbidity, mainly hypertension (23/45, 51%) and cardiovascular disease (15/45, 33%). Before CTPA, 5 patients had high D-dimer (11.21 μg/mL, IQR 9.10-13.02), 19 high fibrinogen (550 mg/dL, IQR 476-590), 26 high interleukin-6 (79 pg/mL, IQR 31-282), and 11 high C-reactive protein (9.60 mg/dL, IQR 6.75-10.65), C-reactive protein being the only laboratory parameter significantly differing between patients with and without PTE (P = .002)High PTE incidence (60%) in COVID-19 hospitalized patients under prophylactic LMWH could substantiate further tailoring of anticoagulation therapy.