Pulmonary thromboembolism in coronavirus disease 2019 patients undergoing thromboprophylaxis. Issue 1 (8th January 2021)

• Record Type: Journal Article
• Authors: Schiaffino, Simone; Giacomazzi, Francesca; Esseridou, Anastassia; Cozzi, Andrea; Carriero, Serena; Mazzaccaro, Daniela P.; Nano, Giovanni; Di Leo, Giovanni; Spagnolo, Pietro; Sardanelli, Francesco
• Other Names: Schildgen. Oliver section editor.
• Is Part Of: Medicine. Volume 100:Issue 1(2021)
• Publication Date: 2021-01-08
• Subjects: computed tomography angiography -- coronavirus -- coronavirus disease 2019 -- heparin -- low-molecular-weight -- pulmonary embolism; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000024002
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract : Abstract: We aimed to investigate the prevalence of pulmonary thromboembolism (PTE) and its association with clinical variables in a cohort of hospitalized coronavirus disease 2019 (COVID-19) patients receiving low-molecular-weight heparin (LMWH) at prophylactic dosage. In this retrospective observational study we included COVID-19 patients receiving prophylactic LMWH from admission but still referred for lower-limbs venous Doppler ultrasound (LL-US) and computed tomography pulmonary angiography (CTPA) for clinical PTE suspicion. A dedicated radiologist reviewed CTPA images to assess PTE presence/extension. From March 1 to April 30, 2020, 45 patients were included (34 men, median age 67 years, interquartile range [IQR] 60–76). Twenty-seven (60%) had PTE signs at CTPA, 17/27 (63%) with bilateral involvement, none with main branch PTE. In 33/45 patients (73%) patients LL-US was performed before CTPA, with 3 patients having superficial vein thrombosis (9%, none with CTPA-confirmed PTE) and 1 patient having deep vein thrombosis (3%, with CTPA-confirmed PTE). Thirty-three patients (73%) had at least one comorbidity, mainly hypertension (23/45, 51%) and cardiovascular disease (15/45, 33%). Before CTPA, 5 patients had high D-dimer (11.21 μg/mL, IQR 9.10–13.02), 19 high fibrinogen (550 mg/dL, IQR 476–590), 26 high interleukin-6 (79 pg/mL, IQR 31–282), and 11 high C-reactive protein (9.60 mg/dL, IQR 6.75–10.65), C-reactive protein being the only laboratory parameter significantly differing between patients with and without PTE ( P = .002) High PTE incidence (60%) in COVID-19 hospitalized patients under prophylactic LMWH could substantiate further tailoring of anticoagulation therapy.