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COVID‐19 and Venous Thromboembolism in Intensive Care or Medical Ward

Despite thromboprophylaxis, patients with coronavirus disease 2019 (COVID‐19) exhibit hypercoagulability and higher venous thromboembolic risk, although its real incidence is still unknown. The aim of this study was to evaluate the incidence of venous thromboembolism (VTE) in patients with COVID‐19...

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Autores principales: Avruscio, Giampiero, Camporese, Giuseppe, Campello, Elena, Bernardi, Enrico, Persona, Paolo, Passarella, Christian, Noventa, Franco, Cola, Marco, Navalesi, Paolo, Cattelan, Annamaria, Tiberio, Ivo, Boscolo, Annalisa, Spiezia, Luca, Simioni, Paolo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7567296/
https://www.ncbi.nlm.nih.gov/pubmed/32989908
http://dx.doi.org/10.1111/cts.12907
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author Avruscio, Giampiero
Camporese, Giuseppe
Campello, Elena
Bernardi, Enrico
Persona, Paolo
Passarella, Christian
Noventa, Franco
Cola, Marco
Navalesi, Paolo
Cattelan, Annamaria
Tiberio, Ivo
Boscolo, Annalisa
Spiezia, Luca
Simioni, Paolo
author_facet Avruscio, Giampiero
Camporese, Giuseppe
Campello, Elena
Bernardi, Enrico
Persona, Paolo
Passarella, Christian
Noventa, Franco
Cola, Marco
Navalesi, Paolo
Cattelan, Annamaria
Tiberio, Ivo
Boscolo, Annalisa
Spiezia, Luca
Simioni, Paolo
author_sort Avruscio, Giampiero
collection PubMed
description Despite thromboprophylaxis, patients with coronavirus disease 2019 (COVID‐19) exhibit hypercoagulability and higher venous thromboembolic risk, although its real incidence is still unknown. The aim of this study was to evaluate the incidence of venous thromboembolism (VTE) in patients with COVID‐19 admitted to both intensive care units (ICUs) and medical wards (MWs). Consecutive patients admitted for COVID‐19 to the MW and the ICU at Padua University Hospital, all receiving thromboprophylaxis, underwent systematic ultrasonography of the internal jugular, and the upper and lower limbs veins every 7 days (± 1 day) after the admission; and, if negative, once‐weekly until discharge or death. In case of suspected pulmonary embolism, a multidetector computed tomographic angiography was performed. The primary outcome was the proportion of any deep‐vein thrombosis (DVT) and symptomatic pulmonary embolism in both groups. An extended blood coagulative test was performed as well. From March 4 to April 30, 2020, a total of 85 patients were investigated, 44 (52%) in MWs and 41 (48%) in the ICU. Despite thromboprophylaxis, VTE occurred in 12 patients in the MWs (27.3%) and 31 patients in the ICU (75.6%) with an odds ratio of 9.3 (95% confidence interval (CI) 3.5–24.5; P < 0.001). Multiple‐site DVT occurred in 55.6% of patients (95% CI 39.6–70.5). Increased D‐dimer levels significantly correlated with VTE (P = 0.001) and death (P = 0.015). Summarizing, patients with COVID‐19 admitted to the MW or ICU showed a high frequency of venous thromboembolism, despite standard‐dose or high‐dose thromboprophylaxis. Whether thrombosis, particularly asymptomatic events, may play a role in the morbidity and mortality of patients with COVID‐19 remain to be clarified.
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spelling pubmed-75672962020-10-19 COVID‐19 and Venous Thromboembolism in Intensive Care or Medical Ward Avruscio, Giampiero Camporese, Giuseppe Campello, Elena Bernardi, Enrico Persona, Paolo Passarella, Christian Noventa, Franco Cola, Marco Navalesi, Paolo Cattelan, Annamaria Tiberio, Ivo Boscolo, Annalisa Spiezia, Luca Simioni, Paolo Clin Transl Sci Research Despite thromboprophylaxis, patients with coronavirus disease 2019 (COVID‐19) exhibit hypercoagulability and higher venous thromboembolic risk, although its real incidence is still unknown. The aim of this study was to evaluate the incidence of venous thromboembolism (VTE) in patients with COVID‐19 admitted to both intensive care units (ICUs) and medical wards (MWs). Consecutive patients admitted for COVID‐19 to the MW and the ICU at Padua University Hospital, all receiving thromboprophylaxis, underwent systematic ultrasonography of the internal jugular, and the upper and lower limbs veins every 7 days (± 1 day) after the admission; and, if negative, once‐weekly until discharge or death. In case of suspected pulmonary embolism, a multidetector computed tomographic angiography was performed. The primary outcome was the proportion of any deep‐vein thrombosis (DVT) and symptomatic pulmonary embolism in both groups. An extended blood coagulative test was performed as well. From March 4 to April 30, 2020, a total of 85 patients were investigated, 44 (52%) in MWs and 41 (48%) in the ICU. Despite thromboprophylaxis, VTE occurred in 12 patients in the MWs (27.3%) and 31 patients in the ICU (75.6%) with an odds ratio of 9.3 (95% confidence interval (CI) 3.5–24.5; P < 0.001). Multiple‐site DVT occurred in 55.6% of patients (95% CI 39.6–70.5). Increased D‐dimer levels significantly correlated with VTE (P = 0.001) and death (P = 0.015). Summarizing, patients with COVID‐19 admitted to the MW or ICU showed a high frequency of venous thromboembolism, despite standard‐dose or high‐dose thromboprophylaxis. Whether thrombosis, particularly asymptomatic events, may play a role in the morbidity and mortality of patients with COVID‐19 remain to be clarified. John Wiley and Sons Inc. 2020-10-23 2020-11 /pmc/articles/PMC7567296/ /pubmed/32989908 http://dx.doi.org/10.1111/cts.12907 Text en © 2020 The Authors. Clinical and Translational Science published by Wiley Periodicals LLC on behalf of the American Society for Clinical Pharmacology and Therapeutics. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Research
Avruscio, Giampiero
Camporese, Giuseppe
Campello, Elena
Bernardi, Enrico
Persona, Paolo
Passarella, Christian
Noventa, Franco
Cola, Marco
Navalesi, Paolo
Cattelan, Annamaria
Tiberio, Ivo
Boscolo, Annalisa
Spiezia, Luca
Simioni, Paolo
COVID‐19 and Venous Thromboembolism in Intensive Care or Medical Ward
title COVID‐19 and Venous Thromboembolism in Intensive Care or Medical Ward
title_full COVID‐19 and Venous Thromboembolism in Intensive Care or Medical Ward
title_fullStr COVID‐19 and Venous Thromboembolism in Intensive Care or Medical Ward
title_full_unstemmed COVID‐19 and Venous Thromboembolism in Intensive Care or Medical Ward
title_short COVID‐19 and Venous Thromboembolism in Intensive Care or Medical Ward
title_sort covid‐19 and venous thromboembolism in intensive care or medical ward
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7567296/
https://www.ncbi.nlm.nih.gov/pubmed/32989908
http://dx.doi.org/10.1111/cts.12907
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