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

Autor: da Silveira WC; Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627, Belo Horizonte, Brazil. warleysilveira@gmail.com.; University Hospital, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena, 110, Santa Efigênia, Belo Horizonte, MG, CEP 30130-100, Brazil. warleysilveira@gmail.com., Ramos LEF; Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627, Belo Horizonte, Brazil., Silva RT; Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627, Belo Horizonte, Brazil., de Paiva BBM; Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627, Belo Horizonte, Brazil., Pereira PD; Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627, Belo Horizonte, Brazil.; Institute for Health Technology Assessment (IATS/ CNPq), Rua Ramiro Barcelos, 2359, Prédio 21 | Sala 507, Porto Alegre, Brazil., Schwarzbold AV; Hospital Universitário de Santa Maria, Av. Roraima, 1000, prédio 22, Santa Maria, Brazil., Garbini AF; Hospital Nossa Senhora da Conceição and Hospital Cristo Redentor, Av. Francisco Trein, 326, Porto Alegre, Brazil., Barreira BSM; Pontifícia Universidade Católica de Minas Gerais, Rua do Rosário 1081, Betim, Brazil., de Castro BM; Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350, Porto Alegre, Brazil., Ramos CM; Hospital Julia Kubitschek, Rua Dr. Cristiano Rezende, 2745, Belo Horizonte, Brazil., Gomes CD; Hospital Mãe de Deus, Rua José de Alencar, 286, Porto Alegre, Brazil., Cimini CCR; Mucuri Medical School - FAMMUC, Universidade Federal dos Vales do Jequitinhonha e Mucuri - UFVJM, Rua Cruzeiro, 01, Teófilo Otoni, Brazil.; Hospital Santa Rosalia, Rua do Cruzeiro, 01, Teófilo Otoni, Brazil., Pereira EC; Hospital SOS Cárdio, Rodovia, SC-401, 121, Florianópolis, Brazil., Roesch EW; Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350, Porto Alegre, Brazil., Kroger EMS; Hospital Julia Kubitschek, Rua Dr. Cristiano Rezende, 2745, Belo Horizonte, Brazil., Aranha FFMG; Universidade do Sul de Santa Catarina, Av. Pedra Branca, 25, Palhoça, Brazil., Anschau F; Hospital Nossa Senhora da Conceição and Hospital Cristo Redentor, Av. Francisco Trein, 326, Porto Alegre, Brazil., Botoni FA; Hospital Julia Kubitschek, Rua Dr. Cristiano Rezende, 2745, Belo Horizonte, Brazil., Aranha FG; Hospital SOS Cárdio, Rodovia, SC-401, 121, Florianópolis, Brazil., Crestani GP; Hospital Mãe de Deus, Rua José de Alencar, 286, Porto Alegre, Brazil., Vietta GG; Hospital SOS Cárdio, Rodovia, SC-401, 121, Florianópolis, Brazil., Bastos GAN; Hospital Moinhos de Vento, Rua Ramiro Barcelos, 910, Porto Alegre, Brazil., Costa JHSM; Hospital Márcio Cunha, Av. Kiyoshi Tsunawaki, 48, Ipatinga, Brazil., da Fonseca JRCS; Hospital Semper, Alameda Ezequiel Dias, 389, Belo Horizonte, Brazil., Ruschel KB; Institute for Health Technology Assessment (IATS/ CNPq), Rua Ramiro Barcelos, 2359, Prédio 21 | Sala 507, Porto Alegre, Brazil.; Hospital Mãe de Deus, Rua José de Alencar, 286, Porto Alegre, Brazil., de Oliveira LS; Hospital Santa Rosalia, Rua do Cruzeiro, 01, Teófilo Otoni, Brazil., Pinheiro LS; Hospital Santa Rosalia, Rua do Cruzeiro, 01, Teófilo Otoni, Brazil., Pacheco LS; Hospital Universitário de Santa Maria, Av. Roraima, 1000, prédio 22, Santa Maria, Brazil., Segala LB; Hospital Universitário de Santa Maria, Av. Roraima, 1000, prédio 22, Santa Maria, Brazil., Couto LSF; Universidade Federal de Ouro Preto, Rua Diogo de Vasconcelos, 122, Ouro Preto, Brazil., Kopittke L; Hospital Nossa Senhora da Conceição and Hospital Cristo Redentor, Av. Francisco Trein, 326, Porto Alegre, Brazil., Floriani MA; Hospital Moinhos de Vento, Rua Ramiro Barcelos, 910, Porto Alegre, Brazil., Silva MM; Hospital Moinhos de Vento, Rua Ramiro Barcelos, 910, Porto Alegre, Brazil., Carneiro M; Hospital Santa Cruz, Rua Fernando Abott, 174, Santa Cruz do Sul, Brazil., Ferreira MAP; Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350, Porto Alegre, Brazil., Martins MAP; Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627, Belo Horizonte, Brazil., de Faria MNZ; Hospital Julia Kubitschek, Rua Dr. Cristiano Rezende, 2745, Belo Horizonte, Brazil., Nogueira MCA; Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627, Belo Horizonte, Brazil.; Hospitais da Rede Mater Dei, Av. do Contorno, 9000, Belo Horizonte, Brazil., Guimarães Júnior MH; Hospital Márcio Cunha, Av. Kiyoshi Tsunawaki, 48, Ipatinga, Brazil., Sampaio NDCS; Hospital Eduardo de Menezes, Rua Dr. Cristiano Rezende, 2213, Belo Horizonte, Brazil., de Oliveira NR; Hospital Eduardo de Menezes, Rua Dr. Cristiano Rezende, 2213, Belo Horizonte, Brazil., Pertile NM; Hospital Moinhos de Vento, Rua Ramiro Barcelos, 910, Porto Alegre, Brazil., Andrade PGS; Hospital Semper, Alameda Ezequiel Dias, 389, Belo Horizonte, Brazil., Assaf PL; Hospital Metropolitano Doutor Célio de Castro, Rua Dona Luiza, 311, Belo Horizonte, Brazil., Valacio RA; Hospital Metropolitano Odilon Behrens, Rua Formiga, 50, Belo Horizonte, Brazil., Menezes RM; Hospital Santa Cruz, Rua Fernando Abott, 174, Santa Cruz do Sul, Brazil., Francisco SC; Hospital Metropolitano Doutor Célio de Castro, Rua Dona Luiza, 311, Belo Horizonte, Brazil., Guimarães SMM; Hospital Semper, Alameda Ezequiel Dias, 389, Belo Horizonte, Brazil., Araújo SF; Hospital Semper, Alameda Ezequiel Dias, 389, Belo Horizonte, Brazil., Rezende SM; Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627, Belo Horizonte, Brazil., Pereira SA; Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627, Belo Horizonte, Brazil., Kurtz T; Hospital Santa Cruz, Rua Fernando Abott, 174, Santa Cruz do Sul, Brazil., Fereguetti TO; Hospital Eduardo de Menezes, Rua Dr. Cristiano Rezende, 2213, Belo Horizonte, Brazil., Polanczyk CA; Institute for Health Technology Assessment (IATS/ CNPq), Rua Ramiro Barcelos, 2359, Prédio 21 | Sala 507, Porto Alegre, Brazil., Pires MC; Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627, Belo Horizonte, Brazil., Gonçalves MA; Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627, Belo Horizonte, Brazil.; Institute for Health Technology Assessment (IATS/ CNPq), Rua Ramiro Barcelos, 2359, Prédio 21 | Sala 507, Porto Alegre, Brazil., Marcolino MS; Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627, Belo Horizonte, Brazil.; Institute for Health Technology Assessment (IATS/ CNPq), Rua Ramiro Barcelos, 2359, Prédio 21 | Sala 507, Porto Alegre, Brazil.; Telehealth Center, University Hospital, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena, 110, Belo Horizonte, Brazil.
Jazyk: angličtina
Zdroj: Internal and emergency medicine [Intern Emerg Med] 2022 Oct; Vol. 17 (7), pp. 1863-1878. Date of Electronic Publication: 2022 Jun 01.
DOI: 10.1007/s11739-022-03002-z
Abstrakt: 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.
(© 2022. The Author(s), under exclusive licence to Società Italiana di Medicina Interna (SIMI).)
Databáze: MEDLINE
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