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Incidence of venous thromboembolism in coronavirus disease 2019: An experience from a single large academic center

2020; Elsevier BV; Volume: 9; Issue: 3 Linguagem: Inglês

10.1016/j.jvsv.2020.09.006

2213-3348

Parth Rali, O.A. O’Corragain, Lawrence Oresanya, Daohai Yu, Omar Sheriff, Robert A. Weiss, C.N. Myers, Parag Desai, Nadia Ali, Anthony Stack, Michael Bromberg, Andrea L. Lubitz, J. Panaro, Riyaz Bashir, Vladimir Lakhter, Roberto Caricchio, Rohit Gupta, Chandra Dass, Maruti Kumaran, Xiaoning Lu, A. Koneti Rao, Gary Cohen, Gerard J. Criner, Eric T. Choi, Aaron Mishkin, Abbas Abba, Abhijit Pathak, Abhinav Rastogi, Adam Diamond, Aditi Satti, Adria Simon, Ahmed M. Soliman, Alan Braveman, A.J. Mamary, A. Pandya, Amy J. Goldberg, Amy Kambo, A.J. Gangemi, Anjali Vaidya, Ann Davison, Anuj Basil, Beata Kośmider, Charles Bakhos, Bill Cornwell, Brianna Sanguily, Brittany Corso, Carla Grabianowski, Carly Sedlock, C.N. Myers, C.N. Myers, Charles Bakhos, Chenna Kesava Reddy Mandapati, Cherie P. Erkmen, Chethan Gangireddy, Chih-Ru Lin, Christopher T. Burks, Claire Raab, Deborah L. Crabbe, Crystal Chen, Daniel Edmundowicz, D. Sacher, Daniel Salerno, Daniele Simon, David M. Ambrose, David Ciccolella, Debra Gillman, Dolores Fehrle, Dominic Morano, Donnalynn Bassler, Edmund Cronin, Eduardo Dominguez, E.S. Randhawa, Ekamjeet Randhawa, Eman Hamad, Eneida Male, Erin Narewski, Francis Cordova, Frederic Jaffe, Frederich Kueppers, Fusun Dikengil, Jonathan J. Galli, A.J. Gangemi, Jamie L. Garfield, Gayle M Jones, Gennaro Calendo, Gerard J. Criner, Gilbert E. D’Alonzo, Ginny Marmolejos, Matthew Gordon, G. Millio, Rohit Gupta, Fernandez Gustavo, Hannah Leah Tadeja Simborio, Harwood Scott, Heidi Shore-Brown, H S Villanueva Alvarado, Ho‐Man Yeung, Ibraheem Yousef, I. Oriaku, Iris Jung-won Lee, Isaac R. Whitman, James C. Brown, Jamie L. Garfield, Janpreet Mokha, Jason C Gallagher, Jeffrey Stewart, Jenna Murray, Jessica Tang, Jeyssa Gonzalez, Jichuan Wu, Jiji Thomas, J. Murrett, Joanna Beros, John M. Travaline, Jolly Varghese, Jordan Senchak, Joseph Lambert, Joseph Ramzy, Joshua Cooper, Jun Song, Junad Chowdhury, Kaitlin Kennedy, Karim Bahmed, Karim Loukmane, K.T. Shenoy, Kathleen Brennan, Keith A. Johnson, Kevin Carney, Kraftin E. Schreyer, Kristin Criner, Maruti Kumaran, Lauren E. Miller, Laurie Jameson, Laurie A. Johnson, Laurie E. Kilpatrick, Lii-Yoong H. Criner, Lily Zhang, Lindsay K. McGann, Llera A. Samuels, Marc Diamon, Margaret Kerper, Maria Vega Sanchez, Mariola Marcinkienwicz, Maritza Pedlar, Mark O. Aksoy, Mark H. Weir, Marla R. Wolfson, Marla R. Wolfson, R. Marron, Martin Keane, M. Zantah, Mathew Zheng, Matthew Delfiner, Matthew Gordon, M. Patel, Megan Healy, Melinda Darnell, Melinda Darnell, Melissa Navaro, Meredith A. Brisco‐Bacik, Michael Bromberg, Michael Gannon, Michael Jacobs, Mira Mandal, Nanzhou Gou, Erin Narewski, Nathaniel Marchetti, Nathaniel Xander, Navjot Kaur, Neil Nadpara, N. R. Desai, N. Mills, Norihisa Shigemura, Ohoud Rehbini, O.A. O’Corragain, Omar Sheriff, Oneida A. Arosarena, Osheen Abramian, Paige Stanley, Parag Desai, Parth Rali, P. Mulhall, Pravin O. Patil, Priju Varghe, Puja Dubal, Puja Patel, Rachael Hageman Blair, RAJAGOPALAN RENGAN, R. Alashram, Randol W. Hooper, Rebecca A. Armbruster, Regina Sheriden, R. Marron, Roberto Caricchio, Rogers Thomas, Rohit Gupta, Rohit Soans, Roman Petrov, Roman Prosniak, Romulo Fajardo, Ruchi Bhutani, Ryan Townsend, Sabrina Islam, S. Pettigrew, Samantha Wallace, Sameep Sehgal, Samuel L. Krachman, Santosh Dhungana, Sarah Hoang, Sean Duffy, Seema Rani, Shapiro William, Sheila Weaver, Shelu Benny, Sheril George, Shuang Sun, Shubhra Srivastava-Malhotra, Stephanie Brictson, Stephanie Spivack, Stephanie Tittaferrante, S.E. Yerkes, S. Priest, S. Codella, Steven G. Kelsen, Steven M. Houser, S. Verga, Sudhir Bolla, Sudhir Kotnala, Sunil Karhadkar, S.C. Johnson, T Shariff, Tammy Jacobs, Thomas N. Hooper, Thomas R. Rogers, Tony S. Reed, Tse-Shuen Ku, Uma S. Sajjan, V. Kim, Whitney Cabey, Wissam Chatila, Wuyan Li, Zach Dorey-Stein, Z. Dorey-Stein, Zachary Repanshek,

Venous Thromboembolism Diagnosis and Management

Infection with the novel severe acute respiratory syndrome coronavirus 2 has been associated with a hypercoagulable state. Emerging data from China and Europe have consistently shown an increased incidence of venous thromboembolism (VTE). We aimed to identify the VTE incidence and early predictors of VTE at our high-volume tertiary care center.We performed a retrospective cohort study of 147 patients who had been admitted to Temple University Hospital with coronavirus disease 2019 (COVID-19) from April 1, 2020 to April 27, 2020. We first identified the VTE (pulmonary embolism [PE] and deep vein thrombosis [DVT]) incidence in our cohort. The VTE and no-VTE groups were compared by univariable analysis for demographics, comorbidities, laboratory data, and treatment outcomes. Subsequently, multivariable logistic regression analysis was performed to identify the early predictors of VTE.The 147 patients (20.9% of all admissions) admitted to a designated COVID-19 unit at Temple University Hospital with a high clinical suspicion of acute VTE had undergone testing for VTE using computed tomography pulmonary angiography and/or extremity venous duplex ultrasonography. The overall incidence of VTE was 17% (25 of 147). Of the 25 patients, 16 had had acute PE, 14 had had acute DVT, and 5 had had both PE and DVT. The need for invasive mechanical ventilation (adjusted odds ratio, 3.19; 95% confidence interval, 1.07-9.55) and the admission D-dimer level ≥1500 ng/mL (adjusted odds ratio, 3.55; 95% confidence interval, 1.29-9.78) were independent markers associated with VTE. The all-cause mortality in the VTE group was greater than that in the non-VTE group (48% vs 22%; P = .007).Our study represents one of the earliest reported from the United States on the incidence rate of VTE in patients with COVID-19. Patients with a high clinical suspicion and the identified risk factors (invasive mechanical ventilation, admission D-dimer level ≥1500 ng/mL) should be considered for early VTE testing. We did not screen all patients admitted for VTE; therefore, the true incidence of VTE could have been underestimated. Our findings require confirmation in future prospective studies.