Incidence of venous thromboembolism in hospitalized patients with COVID-19.
| Title: | Incidence of venous thromboembolism in hospitalized patients with COVID-19. |
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| Authors: | Middeldorp S; Department of Vascular Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.; Coppens M; Department of Vascular Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.; van Haaps TF; Department of Vascular Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.; Foppen M; Department of Vascular Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.; Vlaar AP; Department of Intensive Care Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.; Müller MCA; Department of Intensive Care Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.; Bouman CCS; Department of Intensive Care Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.; Beenen LFM; Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.; Kootte RS; Department of Acute Internal Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.; Heijmans J; Department of Acute Internal Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.; Smits LP; Department of Acute Internal Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.; Bonta PI; Department of Pulmonary Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.; van Es N; Department of Vascular Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. |
| Source: | Journal of thrombosis and haemostasis : JTH [J Thromb Haemost] 2020 Aug; Vol. 18 (8), pp. 1995-2002. Date of Electronic Publication: 2020 Jul 27. |
| Publication Type: | Comparative Study; Journal Article |
| Language: | English |
| Journal Info: | Publisher: Elsevier Country of Publication: England NLM ID: 101170508 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1538-7836 (Electronic) Linking ISSN: 15387836 NLM ISO Abbreviation: J Thromb Haemost Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2023- : [New York] : Elsevier; Original Publication: Oxford : Blackwell Pub. |
| MeSH Terms: | Betacoronavirus* ; Pandemics*; Coronavirus Infections/*blood ; Pneumonia, Viral/*blood ; Pulmonary Embolism/*epidemiology ; Venous Thromboembolism/*epidemiology ; Venous Thrombosis/*epidemiology; Anticoagulants/therapeutic use ; Catheterization, Central Venous/adverse effects ; Coronavirus Infections/complications ; Fibrin Fibrinogen Degradation Products/analysis ; Intensive Care Units/statistics & numerical data ; Netherlands/epidemiology ; Patients' Rooms/statistics & numerical data ; Pneumonia, Viral/complications ; Pulmonary Embolism/blood ; Pulmonary Embolism/diagnostic imaging ; Pulmonary Embolism/etiology ; Thrombophilia/drug therapy ; Thrombophilia/etiology ; Thrombophlebitis/epidemiology ; Thrombophlebitis/etiology ; Venous Thromboembolism/blood ; Venous Thromboembolism/diagnostic imaging ; Venous Thromboembolism/etiology ; Venous Thrombosis/blood ; Venous Thrombosis/diagnostic imaging ; Venous Thrombosis/etiology ; Aged ; Biomarkers ; COVID-19 ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; SARS-CoV-2 |
| Abstract: | Background: Coronavirus disease 2019 (COVID-19) can lead to systemic coagulation activation and thrombotic complications.; Objectives: To investigate the incidence of objectively confirmed venous thromboembolism (VTE) in hospitalized patients with COVID-19.; Methods: Single-center cohort study of 198 hospitalized patients with COVID-19.; Results: Seventy-five patients (38%) were admitted to the intensive care unit (ICU). At time of data collection, 16 (8%) were still hospitalized and 19% had died. During a median follow-up of 7 days (IQR, 3-13), 39 patients (20%) were diagnosed with VTE of whom 25 (13%) had symptomatic VTE, despite routine thrombosis prophylaxis. The cumulative incidences of VTE at 7, 14 and 21 days were 16% (95% CI, 10-22), 33% (95% CI, 23-43) and 42% (95% CI 30-54) respectively. For symptomatic VTE, these were 10% (95% CI, 5.8-16), 21% (95% CI, 14-30) and 25% (95% CI 16-36). VTE appeared to be associated with death (adjusted HR, 2.4; 95% CI, 1.02-5.5). The cumulative incidence of VTE was higher in the ICU (26% (95% CI, 17-37), 47% (95% CI, 34-58), and 59% (95% CI, 42-72) at 7, 14 and 21 days) than on the wards (any VTE and symptomatic VTE 5.8% (95% CI, 1.4-15), 9.2% (95% CI, 2.6-21), and 9.2% (2.6-21) at 7, 14, and 21 days).; Conclusions: The observed risk for VTE in COVID-19 is high, particularly in ICU patients, which should lead to a high level of clinical suspicion and low threshold for diagnostic imaging for DVT or PE. Future research should focus on optimal diagnostic and prophylactic strategies to prevent VTE and potentially improve survival.; (© 2020 The Authors. Journal of Thrombosis and Haemostasis published by Wiley Periodicals LLC on behalf of International Society on Thrombosis and Haemostasis.) |
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| Contributed Indexing: | Keywords: COVID-19; critically ill; low-molecular-weight heparin; pulmonary embolism; venous thrombosis |
| Substance Nomenclature: | 0 (Anticoagulants); 0 (Biomarkers); 0 (Fibrin Fibrinogen Degradation Products); 0 (fibrin fragment D) |
| Entry Date(s): | Date Created: 20200506 Date Completed: 20200814 Latest Revision: 20230829 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC7497052 |
| DOI: | 10.1111/jth.14888 |
| PMID: | 32369666 |
| Database: | MEDLINE |
Comparative Study; Journal Article