Pulmonary embolism and screening for concomitant proximal deep vein thrombosis in noncritically ill hospitalized patients with coronavirus disease 2019
| Autor: | Álvaro Mena, Patricia Piñeiro-Parga, Santiago Freire-Castro, Cristina Barbagelata-López, Álvaro Dubois-Silva, Diego Llinares-García |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Deep vein Pneumonia Viral Comorbidity Risk Assessment Severity of Illness Index Hospitals University Coagulopathy Internal medicine Deep vein thrombosis Severity of illness CE-Research Letter to the Editor Internal Medicine medicine Prevalence Humans Mass Screening Pandemics Aged Venous Thrombosis Inpatients Coronavirus disease 2019 business.industry Pulmonary embolism Anticoagulants COVID-19 Middle Aged medicine.disease Thrombosis Survival Analysis Pneumonia Intensive Care Units medicine.anatomical_structure Cross-Sectional Studies Spain Concomitant Emergency Medicine Cardiology Screening Female business Coronavirus Infections Tomography X-Ray Computed Follow-Up Studies |
| Zdroj: | Internal and Emergency Medicine |
| DOI: | 10.21203/rs.3.rs-30389/v1 |
| Popis: | Background The clinical characteristics of noncritically ill patients with coronavirus disease 2019 (COVID-19) who develop pulmonary embolism (PE) and the prevalence of concomitant proximal deep-vein thrombosis (DVT) of the lower limbs have not been evaluated consistently.Methods We identified nonintensive care unit (non-ICU) patients admitted with COVID-19 who were diagnosed with PE at a single center in northwest Spain. Point-of-care compression ultrasonography (CUS) of the lower limbs was performed to screen for concomitant proximal DVT. Clinical data were analyzed retrospectively.Results From April 2 to April 17, 2020, 8 patients with COVID-19 and PE were identified. PE was diagnosed a median of 19 (interquartile range [IQR], 17–23) days after onset of COVID-19 symptoms and a median of 13 (IQR, 8–15) days after admission. All patients received thromboprophylaxis with enoxaparin or biosimilar at a median dose of 40 mg. All tested patients had high levels of D-dimer (≥2000 ng/mL), serum ferritin (≥300 mg/dL) and IL-6 (≥5 pg/mL) at PE diagnosis. Six (75%) and 7 (87.5%) patients had high C-reactive-protein (≥1 mg/dL) and lactate dehydrogenase (≥250 U/L) levels, respectively. All PE events were segmental or subsegmental, with lobar involvement in only one. None of these patients had concomitant proximal DVT of the lower limbs on CUS.Conclusions Non-ICU hospitalized patients with COVID-19 diagnosed with PE had mainly segmental or subsegmental events without concomitant proximal DVT of the lower limbs. Our findings suggest a predominance of small-vessel thrombosis secondary to inflammatory and immune responses in these patients. |
| Databáze: | OpenAIRE |
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