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.
Journal article

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.

  • Kampouri E Service of Infectious Diseases, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.
  • Filippidis P Service of Infectious Diseases, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.
  • Viala B Service of Infectious Diseases, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.
  • Méan M Division of Internal Medicine, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.
  • Pantet O Service of Intensive Care, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.
  • Desgranges F Service of Infectious Diseases, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.
  • Tschopp J Service of Infectious Diseases, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.
  • Regina J Service of Infectious Diseases, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.
  • Karachalias E Starling Bank Limited, London, UK.
  • Bianchi C Division of Internal Medicine, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.
  • Zermatten MG Service of Hematology and Central Hematology Laboratory, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.
  • Jaton K Institute of Microbiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Switzerland.
  • Qanadli SD Cardiothoracic and Vascular Division, Department of Diagnostic and Interventional Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.
  • Bart PA Division of Internal Medicine, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.
  • Pagani JL Service of Intensive Care, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.
  • Guery B Service of Infectious Diseases, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.
  • Alberio L Service of Hematology and Central Hematology Laboratory, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.
  • Papadimitriou-Olivgeris M Service of Infectious Diseases, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.
  • RegCOVID Research Group Service of Infectious Diseases, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.
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  • 2020-11-18
Published in:
  • BioMed research international. - 2020
English 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.
Language
  • English
Open access status
gold
Identifiers
Persistent URL
https://sonar.ch/global/documents/261756
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