Predicting venous thromboembolic events in patients with coronavirus disease 2019 requiring hospitalization: an observational retrospective study by the COVIDIC …

E Kampouri, P Filippidis, B Viala… - BioMed research …, 2020 - Wiley Online Library
E Kampouri, P Filippidis, B Viala, M Méan, O Pantet, F Desgranges, J Tschopp, J Regina
BioMed research international, 2020Wiley Online Library
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 …
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.
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