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Venous thromboembolism and COVID-19: a single center experience from an academic tertiary referral hospital of Northern Italy

2020; Springer Science+Business Media; Volume: 16; Issue: 5 Linguagem: Inglês

10.1007/s11739-020-02550-6

1970-9366

Federica Melazzini, Marta Colaneri, F Fumoso, Giulia Freddi, Marco Vincenzo Lenti, Teresa Chiara Pieri, Davide Piloni, Patrizia Noris, Carla Pieresca, Paola Preti, Mariaconcetta Russo, Angelo Guido Corsico, Guido Tavazzi, Fausto Baldanti, Antonio Triarico, Francesco Mojoli, Raffaele Bruno, Antonio Di Sabatino, Nicola Aronico, Gaetano Bergamaschi, Giampiera Bertolino, Silvia Codega, Filippo Costanzo, Roberto Cresci, Angela Delliponti, Giuseppe Derosa, M. Di Stefano, Francesco Falaschi, Carmine Iadarola, Elisabetta Lovati, Pietro Carlo Lucotti, Alessandra Martignoni, Caterina Mengoli, Emanuela Miceli, Amedeo Mugellini, Chiara Muggia, Elisabetta Pagani, Ilaria Palumbo, Alessandro Pecci, Tiziano Perrone, C. Sgarlata, Luisa Siciliani, Andrea Staniscia, Francesca Torello Vjera, Giovanna Achilli, Andrea Agostinelli, Valentina Antoci, Alessia Ballesio, F Banfi, Chiara Barteselli, Irene Benedetti, F. Borrelli De Andreis, M Brattoli, Francesca Calabretta, Ginevra Cambiè, Roberta Canta, Federico Conca, Luigi Coppola, Elisa Maria Cremonte, Gabriele Croce, Virginia Del Rio, Francesco Di Terlizzi, Maria Giovanna Ferrari, Sara Ferrari, Anna Fiengo, Tommaso Forni, Chiara Frigerio, Alessandra Fusco, Margherita Gabba, Matteo Garolfi, Antonella Gentile, Giulia Gori, G.F. De Grandi, Paolo Grimaldi, Alice Lampugnani, F Lapia, Federica Lepore, Gianluca Lettieri, Jacopo Mambella, C. Mercanti, Stefania Merli, Francesco Mordà, Alba Nardone, Luca Pace, Lucia Padovini, Alessandro Parodi, Ivan Pellegrino, Lavinia Pitotti, Margherita Reduzzi, Giovanni Rigano, Giovanni Romito, Giorgio Rotola, Umberto Sabatini, Lucia Salvi, Giovanni Santacroce, Jessica Savioli, Simone Soriano, Carmine Spataro, Debora Stefani, Anna Rita Aliberti, Alessandro Amatu, Laura Anfossi, Eric Arisi, Chiara Baldi, Mirko Belliato, Lorenzo Bellini, Alberto Benzi, Germana Bichisao, Antonia Bolongaro, Andrea Bottazzi, Federica Broglia, Giacomo Bruschi, Luca Caneva, Emanuele Capaccio, Valeria Carboni, F Cavalloro, Maria Ciceri, Luca Civardi, Maria Paola Delmonte, E. Domenegati, Federica Ferrari, Fiorenza Ferrari, Marta Ferrari, Marinella Fuardo, Maddalena Margherita Gerletti, Simonetta Gualdana, Marcella Ilardi, Claudia Lo Coco, Giuseppe Maggio, Maria Benedetta Mascia, Simonetta Mencherini, Paola Maria Merati, Silvia Mongodi, A Mori, Federica Morgante, Thekla Niebel, Silvano Noli, Anita Orlando, Michele Pagani, Debora Passador, Simona Pellicori, Luciano Perotti, Raffaella Picchioni, Silvia Poma, Marco Pozzi, Emanuela Preti, Roberta Puce, Danila Katia Radolovich, Gianluca Ragni, Filippo Repossi, Francesca Riccardi, R Rizzardi, Giuseppe Rodi, Emanuela Roldi, Giovanni Romito, Cristina Rossi, G. Sala Gallini, Fabio Sciutti, Debora Sportiello, Giulia Ticozzelli, Federico Visconti, Silvia Zizzi, A Bagliani, Corrado Belotti, Chiara Bossi, Andrea Colombo, Costanza Natalia Julia Colombo, Luca Cremascoli, Valentino Dammassa, Roberto Discepoli, Maria Adelaide Garlando, Filippo Grandini, Andrea Pellegrini, Cecilia Quaranta, Andréa Stella, Francesco Torresani, Mario U. Mondelli, Enrico Brunetti, Angela Di Matteo, Elena Seminari, Laura Maiocchi, Valentina Zuccaro, Layla Pagnucco, B Mariani, Serena Ludovisi, Raffaella Lissandrin, Aldo Parisi, Paolo Sacchi, S.F.A. Patruno, G Michelone, Roberto Gulminetti, Domenico Zanaboni, Stefano Novati, Renato Maserati, P Orsolini, Marco Vecchia, Erika Asperges, Di Filippo A, Margherita Sambo, Simona Biscarini, Matteo Lupi, Silvia Roda, Ilaria Gallazzi, Michele Sachs, Pietro Valsecchi, Alessandra Ferrari, B Mariani, Matteo Bosio, Alessandro Cascina, Valentina Conio, Rita Di Domenica, Anna Donnetta, Elia Fraolini, G Gualtieri, P. Mangiarotti, Francesca Mariani, Federica Meloni, Tiberio Oggionni, L. Pasturenzi, Vanessa Ronzoni, Laura Saracino, Giulia Maria Stella, Stefano Tomaselli, Tommaso Abbate, Giulia Accordino, F Bertuccio, Cecilia Burattini, Elisa Cacciatore, Elena Cattaneo, Vittorio Chino, Manuela Coretti, Matteo Della Zoppa, Cristina Infusino, Sara Lettieri, Valeria Maccabruni, S Mancinelli, Claudio Tirelli, Valentina Vertui,

COVID-19 and healthcare impacts

Abstract 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.