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Venous thromboembolism and COVID-19: a single center experience from an academic tertiary referral hospital of Northern Italy
Preliminary evidence supports the notion that COVID-19 patients may have an increased susceptibility to develop venous thromboembolism (VTE). However, the magnitude of this association still needs to be defined. Furthermore, clinical predictors of thrombogenesis, and the relationship with the inflam...
Autores principales: | , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7648897/ https://www.ncbi.nlm.nih.gov/pubmed/33161478 http://dx.doi.org/10.1007/s11739-020-02550-6 |
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author | Melazzini, Federica Colaneri, Marta Fumoso, Federica Freddi, Giulia Lenti, Marco Vincenzo Pieri, Teresa Chiara Piloni, Davide Noris, Patrizia Pieresca, Carla Preti, Paola Stefania Russo, Mariaconcetta Corsico, Angelo Tavazzi, Guido Baldanti, Fausto Triarico, Antonio Mojoli, Francesco Bruno, Raffaele Di Sabatino, Antonio |
author_facet | Melazzini, Federica Colaneri, Marta Fumoso, Federica Freddi, Giulia Lenti, Marco Vincenzo Pieri, Teresa Chiara Piloni, Davide Noris, Patrizia Pieresca, Carla Preti, Paola Stefania Russo, Mariaconcetta Corsico, Angelo Tavazzi, Guido Baldanti, Fausto Triarico, Antonio Mojoli, Francesco Bruno, Raffaele Di Sabatino, Antonio |
author_sort | Melazzini, Federica |
collection | PubMed |
description | Preliminary evidence supports the notion that COVID-19 patients may have an increased susceptibility to develop venous thromboembolism (VTE). However, the magnitude of this association still needs to be defined. Furthermore, clinical predictors of thrombogenesis, and the relationship with the inflammatory status are currently unknown. On this basis, we conducted a retrospective, observational study on 259 consecutive COVID-19 patients admitted to an academic tertiary referral hospital in Northern Italy between March 19th and April 6th, 2020. Records of COVID-19 patients with a definite VTE event were reviewed for demographic information, co-morbidities, risk factors for VTE, laboratory tests, and anticoagulation treatment. Twenty-five cases among 259 COVID-19 patients developed VTE (9.6%), all of them having a Padua score > 4, although being under standard anticoagulation prophylaxis since hospital admission. In the VTE subcohort, we found a significant positive correlation between platelet count (PLT) and either C reactive protein (CRP) (p < 0.0001) or lactate dehydrogenase (LDH) (p = 0.0013), while a significant inverse correlation was observed between PLT and mean platelet volume (p < 0.0001). Platelet-to-lymphocyte ratio significantly correlated with CRP (p < 0.0001). The majority of VTE patients was male and younger compared to non-VTE patients (p = 0.002 and p = 0.005, respectively). No significant difference was found in d-dimer levels between VTE and non VTE patients, while significantly higher levels of LDH (p = 0.04) and IL-6 (p = 0.04) were observed in VTE patients in comparison to non-VTE patients. In conclusion, our findings showed a quite high prevalence of VTE in COVID-19 patients. Raised inflammatory indexes and increased serum levels of pro-inflammatory cytokines should raise the clinical suspicion of VTE. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s11739-020-02550-6) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-7648897 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-76488972020-11-09 Venous thromboembolism and COVID-19: a single center experience from an academic tertiary referral hospital of Northern Italy Melazzini, Federica Colaneri, Marta Fumoso, Federica Freddi, Giulia Lenti, Marco Vincenzo Pieri, Teresa Chiara Piloni, Davide Noris, Patrizia Pieresca, Carla Preti, Paola Stefania Russo, Mariaconcetta Corsico, Angelo Tavazzi, Guido Baldanti, Fausto Triarico, Antonio Mojoli, Francesco Bruno, Raffaele Di Sabatino, Antonio Intern Emerg Med Im - Original Preliminary evidence supports the notion that COVID-19 patients may have an increased susceptibility to develop venous thromboembolism (VTE). However, the magnitude of this association still needs to be defined. Furthermore, clinical predictors of thrombogenesis, and the relationship with the inflammatory status are currently unknown. On this basis, we conducted a retrospective, observational study on 259 consecutive COVID-19 patients admitted to an academic tertiary referral hospital in Northern Italy between March 19th and April 6th, 2020. Records of COVID-19 patients with a definite VTE event were reviewed for demographic information, co-morbidities, risk factors for VTE, laboratory tests, and anticoagulation treatment. Twenty-five cases among 259 COVID-19 patients developed VTE (9.6%), all of them having a Padua score > 4, although being under standard anticoagulation prophylaxis since hospital admission. In the VTE subcohort, we found a significant positive correlation between platelet count (PLT) and either C reactive protein (CRP) (p < 0.0001) or lactate dehydrogenase (LDH) (p = 0.0013), while a significant inverse correlation was observed between PLT and mean platelet volume (p < 0.0001). Platelet-to-lymphocyte ratio significantly correlated with CRP (p < 0.0001). The majority of VTE patients was male and younger compared to non-VTE patients (p = 0.002 and p = 0.005, respectively). No significant difference was found in d-dimer levels between VTE and non VTE patients, while significantly higher levels of LDH (p = 0.04) and IL-6 (p = 0.04) were observed in VTE patients in comparison to non-VTE patients. In conclusion, our findings showed a quite high prevalence of VTE in COVID-19 patients. Raised inflammatory indexes and increased serum levels of pro-inflammatory cytokines should raise the clinical suspicion of VTE. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s11739-020-02550-6) contains supplementary material, which is available to authorized users. Springer International Publishing 2020-11-08 2021 /pmc/articles/PMC7648897/ /pubmed/33161478 http://dx.doi.org/10.1007/s11739-020-02550-6 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Im - Original Melazzini, Federica Colaneri, Marta Fumoso, Federica Freddi, Giulia Lenti, Marco Vincenzo Pieri, Teresa Chiara Piloni, Davide Noris, Patrizia Pieresca, Carla Preti, Paola Stefania Russo, Mariaconcetta Corsico, Angelo Tavazzi, Guido Baldanti, Fausto Triarico, Antonio Mojoli, Francesco Bruno, Raffaele Di Sabatino, Antonio Venous thromboembolism and COVID-19: a single center experience from an academic tertiary referral hospital of Northern Italy |
title | Venous thromboembolism and COVID-19: a single center experience from an academic tertiary referral hospital of Northern Italy |
title_full | Venous thromboembolism and COVID-19: a single center experience from an academic tertiary referral hospital of Northern Italy |
title_fullStr | Venous thromboembolism and COVID-19: a single center experience from an academic tertiary referral hospital of Northern Italy |
title_full_unstemmed | Venous thromboembolism and COVID-19: a single center experience from an academic tertiary referral hospital of Northern Italy |
title_short | Venous thromboembolism and COVID-19: a single center experience from an academic tertiary referral hospital of Northern Italy |
title_sort | venous thromboembolism and covid-19: a single center experience from an academic tertiary referral hospital of northern italy |
topic | Im - Original |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7648897/ https://www.ncbi.nlm.nih.gov/pubmed/33161478 http://dx.doi.org/10.1007/s11739-020-02550-6 |
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