tetano
Editor, Senior Moderator
Viruses
. 2021 Apr 26;13(5):758.
doi: 10.3390/v13050758.
D-Dimer Level and Neutrophils Count as Predictive and Prognostic Factors of Pulmonary Embolism in Severe Non-ICU COVID-19 Patients
Benjamin Thoreau[SUP] 1 2 [/SUP], Joris Galland[SUP] 3 [/SUP], Maxime Delrue[SUP] 4 [/SUP], Marie Neuwirth[SUP] 4 [/SUP], Alain Stepanian[SUP] 4 [/SUP], Anthony Chauvin[SUP] 5 [/SUP], Azeddine Dellal[SUP] 6 [/SUP], Olivier Nallet[SUP] 7 [/SUP], Melanie Roriz[SUP] 8 [/SUP], Mathilde Devaux[SUP] 9 [/SUP], Jonathan London[SUP] 10 [/SUP], Gonzague Martin-Lecamp[SUP] 11 [/SUP], Antoine Froissart[SUP] 12 [/SUP], Nouara Arab[SUP] 12 [/SUP], Bertrand Ferron[SUP] 13 [/SUP], Marie-Helene Groff[SUP] 14 [/SUP], Viviane Queyrel[SUP] 15 [/SUP], Christine Lorut[SUP] 16 [/SUP], Lucile Regard[SUP] 16 [/SUP], Emilie Berthoux[SUP] 17 [/SUP], Guillaume Bayer[SUP] 18 [/SUP], Chloe Comarmond[SUP] 19 [/SUP], Bertrand Lioger[SUP] 20 [/SUP], Ars?ne Mekinian[SUP] 21 [/SUP], Tali-Anne Szwebel[SUP] 1 [/SUP], Thomas Sen?[SUP] 22 [/SUP], Blanca Amador-Borrero[SUP] 3 [/SUP], Olivier Mangin[SUP] 3 [/SUP], Pierre O Sellier[SUP] 23 [/SUP], Virginie Siguret[SUP] 4 [/SUP], St?phane Mouly[SUP] 3 [/SUP], Jean-Philippe Kevorkian[SUP] 24 [/SUP], Lariboisi?re Covid Group, Dominique Vodovar[SUP] 25 26 [/SUP], Damien Sene[SUP] 3 [/SUP]
Affiliations
Abstract
The incidence of pulmonary embolism (PE) is high during severe Coronavirus Disease 2019 (COVID-19). We aimed to identify predictive and prognostic factors of PE in non-ICU hospitalized COVID-19 patients. In the retrospective multicenter observational CLOTVID cohort, we enrolled patients with confirmed RT-PCR COVID-19 who were hospitalized in a medicine ward and also underwent a CT pulmonary angiography for a PE suspicion. Baseline data, laboratory biomarkers, treatments, and outcomes were collected. Predictive and prognostics factors of PE were identified by using logistic multivariate and by Cox regression models, respectively. A total of 174 patients were enrolled, among whom 86 (median [IQR] age of 66 years [55-77]) had post-admission PE suspicion, with 30/86 (34.9%) PE being confirmed. PE occurrence was independently associated with the lack of long-term anticoagulation or thromboprophylaxis (OR [95%CI], 72.3 [3.6-4384.8]) D-dimers ? 2000 ng/mL (26.3 [4.1-537.8]) and neutrophils ? 7.0 G/L (5.8 [1.4-29.5]). The presence of these two biomarkers was associated with a higher risk of PE (p = 0.0002) and death or ICU transfer (HR [95%CI], 12.9 [2.5-67.8], p < 0.01). In hospitalized non-ICU severe COVID-19 patients with clinical PE suspicion, the lack of anticoagulation, D-dimers ? 2000 ng/mL, neutrophils ? 7.0 G/L, and these two biomarkers combined might be useful predictive markers of PE and prognosis, respectively.
Keywords: COVID-19; D-dimer; ICU transfer; anticoagulation; mortality; neutrophil; predictive factor; prognostic; pulmonary embolism.
. 2021 Apr 26;13(5):758.
doi: 10.3390/v13050758.
D-Dimer Level and Neutrophils Count as Predictive and Prognostic Factors of Pulmonary Embolism in Severe Non-ICU COVID-19 Patients
Benjamin Thoreau[SUP] 1 2 [/SUP], Joris Galland[SUP] 3 [/SUP], Maxime Delrue[SUP] 4 [/SUP], Marie Neuwirth[SUP] 4 [/SUP], Alain Stepanian[SUP] 4 [/SUP], Anthony Chauvin[SUP] 5 [/SUP], Azeddine Dellal[SUP] 6 [/SUP], Olivier Nallet[SUP] 7 [/SUP], Melanie Roriz[SUP] 8 [/SUP], Mathilde Devaux[SUP] 9 [/SUP], Jonathan London[SUP] 10 [/SUP], Gonzague Martin-Lecamp[SUP] 11 [/SUP], Antoine Froissart[SUP] 12 [/SUP], Nouara Arab[SUP] 12 [/SUP], Bertrand Ferron[SUP] 13 [/SUP], Marie-Helene Groff[SUP] 14 [/SUP], Viviane Queyrel[SUP] 15 [/SUP], Christine Lorut[SUP] 16 [/SUP], Lucile Regard[SUP] 16 [/SUP], Emilie Berthoux[SUP] 17 [/SUP], Guillaume Bayer[SUP] 18 [/SUP], Chloe Comarmond[SUP] 19 [/SUP], Bertrand Lioger[SUP] 20 [/SUP], Ars?ne Mekinian[SUP] 21 [/SUP], Tali-Anne Szwebel[SUP] 1 [/SUP], Thomas Sen?[SUP] 22 [/SUP], Blanca Amador-Borrero[SUP] 3 [/SUP], Olivier Mangin[SUP] 3 [/SUP], Pierre O Sellier[SUP] 23 [/SUP], Virginie Siguret[SUP] 4 [/SUP], St?phane Mouly[SUP] 3 [/SUP], Jean-Philippe Kevorkian[SUP] 24 [/SUP], Lariboisi?re Covid Group, Dominique Vodovar[SUP] 25 26 [/SUP], Damien Sene[SUP] 3 [/SUP]
Affiliations
- PMID: 33926038
- DOI: 10.3390/v13050758
Abstract
The incidence of pulmonary embolism (PE) is high during severe Coronavirus Disease 2019 (COVID-19). We aimed to identify predictive and prognostic factors of PE in non-ICU hospitalized COVID-19 patients. In the retrospective multicenter observational CLOTVID cohort, we enrolled patients with confirmed RT-PCR COVID-19 who were hospitalized in a medicine ward and also underwent a CT pulmonary angiography for a PE suspicion. Baseline data, laboratory biomarkers, treatments, and outcomes were collected. Predictive and prognostics factors of PE were identified by using logistic multivariate and by Cox regression models, respectively. A total of 174 patients were enrolled, among whom 86 (median [IQR] age of 66 years [55-77]) had post-admission PE suspicion, with 30/86 (34.9%) PE being confirmed. PE occurrence was independently associated with the lack of long-term anticoagulation or thromboprophylaxis (OR [95%CI], 72.3 [3.6-4384.8]) D-dimers ? 2000 ng/mL (26.3 [4.1-537.8]) and neutrophils ? 7.0 G/L (5.8 [1.4-29.5]). The presence of these two biomarkers was associated with a higher risk of PE (p = 0.0002) and death or ICU transfer (HR [95%CI], 12.9 [2.5-67.8], p < 0.01). In hospitalized non-ICU severe COVID-19 patients with clinical PE suspicion, the lack of anticoagulation, D-dimers ? 2000 ng/mL, neutrophils ? 7.0 G/L, and these two biomarkers combined might be useful predictive markers of PE and prognosis, respectively.
Keywords: COVID-19; D-dimer; ICU transfer; anticoagulation; mortality; neutrophil; predictive factor; prognostic; pulmonary embolism.