Predictors of venous thromboembolism in COVID-19 patients: results of the COVID-19 Brazilian Registry

Previous studies that assessed risk factors for venous thromboembolism (VTE) in COVID-19 patients have shown inconsistent results. Our aim was to investigate VTE predictors by both logistic regression (LR) and machine learning (ML) approaches, due to their potential complementarity. This cohort stud...

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Detalles Bibliográficos
Autores principales: da Silveira, Warley Cezar, Ramos, Lucas Emanuel Ferreira, Silva, Rafael Tavares, de Paiva, Bruno Barbosa Miranda, Pereira, Polianna Delfino, Schwarzbold, Alexandre Vargas, Garbini, Andresa Fontoura, Barreira, Bruna Schettino Morato, de Castro, Bruno Mateus, Ramos, Carolina Marques, Gomes, Caroline Danubia, Cimini, Christiane Corrêa Rodrigues, Pereira, Elayne Crestani, Roesch, Eliane Würdig, Kroger, Emanuele Marianne Souza, Aranha, Felipe Ferraz Martins Graça, Anschau, Fernando, Botoni, Fernando Antonio, Aranha, Fernando Graça, Crestani, Gabriela Petry, Vietta, Giovanna Grunewald, Bastos, Gisele Alsina Nader, Costa, Jamille Hemétrio Salles Martins, da Fonseca, Jéssica Rayane Corrêa Silva, Ruschel, Karen Brasil, de Oliveira, Leonardo Seixas, Pinheiro, Lílian Santos, Pacheco, Liliane Souto, Segala, Luciana Borges, Couto, Luciana Siuves Ferreira, Kopittke, Luciane, Floriani, Maiara Anschau, Silva, Majlla Magalhães, Carneiro, Marcelo, Ferreira, Maria Angélica Pires, Martins, Maria Auxiliadora Parreiras, de Faria, Marina Neves Zerbini, Nogueira, Matheus Carvalho Alves, Guimarães Júnior, Milton Henriques, Sampaio, Natália da Cunha Severino, de Oliveira, Neimy Ramos, Pertile, Nicole de Moraes, Andrade, Pedro Guido Soares, Assaf, Pedro Ledic, Valacio, Reginaldo Aparecido, Menezes, Rochele Mosmann, Francisco, Saionara Cristina, Guimarães, Silvana Mangeon Meirelles, Araújo, Silvia Ferreira, Rezende, Suely Meireles, Pereira, Susany Anastácia, Kurtz, Tatiana, Fereguetti, Tatiani Oliveira, Polanczyk, Carísi Anne, Pires, Magda Carvalho, Gonçalves, Marcos André, Marcolino, Milena Soriano
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2022
Materias:
Im - Original
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9156830/
https://www.ncbi.nlm.nih.gov/pubmed/35648280
http://dx.doi.org/10.1007/s11739-022-03002-z
Descripción
Sumario:Previous studies that assessed risk factors for venous thromboembolism (VTE) in COVID-19 patients have shown inconsistent results. Our aim was to investigate VTE predictors by both logistic regression (LR) and machine learning (ML) approaches, due to their potential complementarity. This cohort study of a large Brazilian COVID-19 Registry included 4120 COVID-19 adult patients from 16 hospitals. Symptomatic VTE was confirmed by objective imaging. LR analysis, tree-based boosting, and bagging were used to investigate the association of variables upon hospital presentation with VTE. Among 4,120 patients (55.5% men, 39.3% critical patients), VTE was confirmed in 6.7%. In multivariate LR analysis, obesity (OR 1.50, 95% CI 1.11–2.02); being an ex-smoker (OR 1.44, 95% CI 1.03–2.01); surgery ≤ 90 days (OR 2.20, 95% CI 1.14–4.23); axillary temperature (OR 1.41, 95% CI 1.22–1.63); D-dimer ≥ 4 times above the upper limit of reference value (OR 2.16, 95% CI 1.26–3.67), lactate (OR 1.10, 95% CI 1.02–1.19), C-reactive protein levels (CRP, OR 1.09, 95% CI 1.01–1.18); and neutrophil count (OR 1.04, 95% CI 1.005–1.075) were independent predictors of VTE. Atrial fibrillation, peripheral oxygen saturation/inspired oxygen fraction (SF) ratio and prophylactic use of anticoagulants were protective. Temperature at admission, SF ratio, neutrophil count, D-dimer, CRP and lactate levels were also identified as predictors by ML methods. By using ML and LR analyses, we showed that D-dimer, axillary temperature, neutrophil count, CRP and lactate levels are risk factors for VTE in COVID-19 patients. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11739-022-03002-z.

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