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Systematic testing for venous thromboembolism in hospitalized patients with COVID-19 and raised D-dimer levels.
Weinberg, Ido; Fernández-Capitán, Carmen; Quintana-Díaz, Manuel; Demelo-Rodriguez, Pablo; García de Casasola, Gonzalo; Fidalgo, Ángeles; Maria Suriñach, Josep; Díaz-Pedroche, Carmen; Galeano-Valle, Francisco; Siniscalchi, Carmine; Visonà, Adriana; Bikdeli, Behnood; Jiménez, David; Monreal, Manuel.
Afiliación
  • Weinberg I; Department of Cardiology, Massachusetts General Hospital, Boston, MA, USA.
  • Fernández-Capitán C; Department of Internal Medicine, Hospital Universitario La Paz, Madrid, Spain.
  • Quintana-Díaz M; Department of Intensive Care Medicine, Hospital Universitario La Paz, Madrid, Spain.
  • Demelo-Rodriguez P; Department of Internal Medicine, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
  • García de Casasola G; Department of Internal Medicine, Hospital IFEMA, Madrid, Spain.
  • Fidalgo Á; Department of Internal Medicine, Hospital Universitario de Salamanca, Salamanca, Spain.
  • Maria Suriñach J; Department of Internal Medicine, Hospital Universitario Vall D'Hebrón, Barcelona, Spain.
  • Díaz-Pedroche C; Department of Internal Medicine, Hospital Universitario 12 de Octubre, Madrid, Spain.
  • Galeano-Valle F; Department of Internal and Emergency Medicine, Angiology Unit, Parma University Hospital, Parma, Italy.
  • Siniscalchi C; Department of Internal and Emergency Medicine, Angiology Unit, Parma University Hospital, Parma, Italy.
  • Visonà A; Department of Vascular Medicine, Ospedale Castelfranco Veneto, Castelfranco Veneto, Italy.
  • Bikdeli B; Yale/YNHH Center for Outcomes Research & Evaluation, New Haven, CT, USA, Cardiovascular Research Foundation, New York, NY, USA.
  • Jiménez D; Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
  • Monreal M; Respiratory Department, Hospital Ramón y Cajal (IRYCIS), Madrid, Spain. Universidad de Alcalá (IRYCIS), Madrid, Spain, CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain.
Thromb Update ; 2: 100029, 2021.
Article en En | MEDLINE | ID: mdl-38620598
ABSTRACT

Background:

Hospitalized patients with COVID-19 and raised D-dimer levels have high rates of venous thromboembolism (VTE).

Methods:

We used data from hospitalized patients with COVID-19 that were tested for pulmonary embolism (PE) or deep vein thrombosis (DVT) because of raised D-dimer levels. We aimed to identify patients at increased risk for VTE.

Results:

From March 25 to July 5th, 2020, 1,306 hospitalized patients with COVID-19 and raised D-dimer levels underwent testing for VTE in 12 centers. In all, 171 of 714 (24%) had PE, and 161 of 810 (20%) had DVT. The median time elapsed from admission to VTE testing was 12 days, and the median time from D-dimer measurement to testing 2 days. Most patients with VTE were men (62%), mean age was 62 â€‹± â€‹15 years, 45% were in an intensive care unit. Overall, 681 patients (52%) received VTE prophylaxis with standard doses, 241 (18%) with intermediate doses and 100 (7.7%) with therapeutic doses of anticoagulants. On multivariable analysis, patients with D-dimer levels >20 times the upper normal range (19% of the whole cohort) were at increased risk for VTE (odds ratio [OR] 3.24; 95%CI 2.18-4.83), as were those with a platelet count <100,000/µL (OR 4.17; 95%CI 1.72-10.0).

Conclusions:

Hospitalized patients with COVID-19 and D-dimer levels >20 times the upper normal range were at an increased risk for VTE. This may help to identify what patients could likely benefit from the use of higher than recommended doses of anticoagulants for VTE prophylaxis.

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Thromb Update Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Thromb Update Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido