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Deep Vein Thrombosis in Hospitalized Patients With COVID-19 in Wuhan, China: Prevalence, Risk Factors, and Outcome.
Zhang, Li; Feng, Xiaokai; Zhang, Danqing; Jiang, Chunguo; Mei, Heng; Wang, Jing; Zhang, Cuihong; Li, Hong; Xia, Xiaoling; Kong, Shuangshuang; Liao, Jia; Jia, Huijun; Pang, Xueqin; Song, Yue; Tian, Ying; Wang, Bin; Wu, Chun; Yuan, Hongliang; Zhang, Yongxing; Li, Yuman; Sun, Wei; Zhang, Yanting; Zhu, Shuangshuang; Wang, Shuyuan; Xie, Yuji; Ge, Shuping; Zhang, Liming; Hu, Yu; Xie, Mingxing.
Afiliação
  • Zhang L; Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Li Zhang, D.Z., J.W., C.Z., H.L., X.X., S.K., J.L., H.J., X.P., Y.S., Y.T., B.W., C.W., H.Y., Yongxing Zhang, Y.L., W.S., Yanting Zhang, S.Z., S.W., Y.X., M.X.).
  • Feng X; Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China (Li Zhang, D.Z., J.W., C.Z., H.L., X.X., S.K., J.L., H.J., X.P., Y.S., Y.T., B.W., C.W., H.Y., Yongxing Zhang, Y.L., W.S., Yanting Zhang, S.Z., S.W., Y.X., M.X).
  • Zhang D; Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Chaoyang Hospital, Capital Medical University, China (X.F., C.J., Liming Zhang).
  • Jiang C; Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Li Zhang, D.Z., J.W., C.Z., H.L., X.X., S.K., J.L., H.J., X.P., Y.S., Y.T., B.W., C.W., H.Y., Yongxing Zhang, Y.L., W.S., Yanting Zhang, S.Z., S.W., Y.X., M.X.).
  • Mei H; Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China (Li Zhang, D.Z., J.W., C.Z., H.L., X.X., S.K., J.L., H.J., X.P., Y.S., Y.T., B.W., C.W., H.Y., Yongxing Zhang, Y.L., W.S., Yanting Zhang, S.Z., S.W., Y.X., M.X).
  • Wang J; Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Chaoyang Hospital, Capital Medical University, China (X.F., C.J., Liming Zhang).
  • Zhang C; Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (H.M., Y.H.).
  • Li H; Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Li Zhang, D.Z., J.W., C.Z., H.L., X.X., S.K., J.L., H.J., X.P., Y.S., Y.T., B.W., C.W., H.Y., Yongxing Zhang, Y.L., W.S., Yanting Zhang, S.Z., S.W., Y.X., M.X.).
  • Xia X; Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China (Li Zhang, D.Z., J.W., C.Z., H.L., X.X., S.K., J.L., H.J., X.P., Y.S., Y.T., B.W., C.W., H.Y., Yongxing Zhang, Y.L., W.S., Yanting Zhang, S.Z., S.W., Y.X., M.X).
  • Kong S; Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Li Zhang, D.Z., J.W., C.Z., H.L., X.X., S.K., J.L., H.J., X.P., Y.S., Y.T., B.W., C.W., H.Y., Yongxing Zhang, Y.L., W.S., Yanting Zhang, S.Z., S.W., Y.X., M.X.).
  • Liao J; Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China (Li Zhang, D.Z., J.W., C.Z., H.L., X.X., S.K., J.L., H.J., X.P., Y.S., Y.T., B.W., C.W., H.Y., Yongxing Zhang, Y.L., W.S., Yanting Zhang, S.Z., S.W., Y.X., M.X).
  • Jia H; Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Li Zhang, D.Z., J.W., C.Z., H.L., X.X., S.K., J.L., H.J., X.P., Y.S., Y.T., B.W., C.W., H.Y., Yongxing Zhang, Y.L., W.S., Yanting Zhang, S.Z., S.W., Y.X., M.X.).
  • Pang X; Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China (Li Zhang, D.Z., J.W., C.Z., H.L., X.X., S.K., J.L., H.J., X.P., Y.S., Y.T., B.W., C.W., H.Y., Yongxing Zhang, Y.L., W.S., Yanting Zhang, S.Z., S.W., Y.X., M.X).
  • Song Y; Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Li Zhang, D.Z., J.W., C.Z., H.L., X.X., S.K., J.L., H.J., X.P., Y.S., Y.T., B.W., C.W., H.Y., Yongxing Zhang, Y.L., W.S., Yanting Zhang, S.Z., S.W., Y.X., M.X.).
  • Tian Y; Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China (Li Zhang, D.Z., J.W., C.Z., H.L., X.X., S.K., J.L., H.J., X.P., Y.S., Y.T., B.W., C.W., H.Y., Yongxing Zhang, Y.L., W.S., Yanting Zhang, S.Z., S.W., Y.X., M.X).
  • Wang B; Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Li Zhang, D.Z., J.W., C.Z., H.L., X.X., S.K., J.L., H.J., X.P., Y.S., Y.T., B.W., C.W., H.Y., Yongxing Zhang, Y.L., W.S., Yanting Zhang, S.Z., S.W., Y.X., M.X.).
  • Wu C; Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China (Li Zhang, D.Z., J.W., C.Z., H.L., X.X., S.K., J.L., H.J., X.P., Y.S., Y.T., B.W., C.W., H.Y., Yongxing Zhang, Y.L., W.S., Yanting Zhang, S.Z., S.W., Y.X., M.X).
  • Yuan H; Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Li Zhang, D.Z., J.W., C.Z., H.L., X.X., S.K., J.L., H.J., X.P., Y.S., Y.T., B.W., C.W., H.Y., Yongxing Zhang, Y.L., W.S., Yanting Zhang, S.Z., S.W., Y.X., M.X.).
  • Zhang Y; Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China (Li Zhang, D.Z., J.W., C.Z., H.L., X.X., S.K., J.L., H.J., X.P., Y.S., Y.T., B.W., C.W., H.Y., Yongxing Zhang, Y.L., W.S., Yanting Zhang, S.Z., S.W., Y.X., M.X).
  • Li Y; Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Li Zhang, D.Z., J.W., C.Z., H.L., X.X., S.K., J.L., H.J., X.P., Y.S., Y.T., B.W., C.W., H.Y., Yongxing Zhang, Y.L., W.S., Yanting Zhang, S.Z., S.W., Y.X., M.X.).
  • Sun W; Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China (Li Zhang, D.Z., J.W., C.Z., H.L., X.X., S.K., J.L., H.J., X.P., Y.S., Y.T., B.W., C.W., H.Y., Yongxing Zhang, Y.L., W.S., Yanting Zhang, S.Z., S.W., Y.X., M.X).
  • Zhang Y; Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Li Zhang, D.Z., J.W., C.Z., H.L., X.X., S.K., J.L., H.J., X.P., Y.S., Y.T., B.W., C.W., H.Y., Yongxing Zhang, Y.L., W.S., Yanting Zhang, S.Z., S.W., Y.X., M.X.).
  • Zhu S; Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China (Li Zhang, D.Z., J.W., C.Z., H.L., X.X., S.K., J.L., H.J., X.P., Y.S., Y.T., B.W., C.W., H.Y., Yongxing Zhang, Y.L., W.S., Yanting Zhang, S.Z., S.W., Y.X., M.X).
  • Wang S; Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Li Zhang, D.Z., J.W., C.Z., H.L., X.X., S.K., J.L., H.J., X.P., Y.S., Y.T., B.W., C.W., H.Y., Yongxing Zhang, Y.L., W.S., Yanting Zhang, S.Z., S.W., Y.X., M.X.).
  • Xie Y; Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China (Li Zhang, D.Z., J.W., C.Z., H.L., X.X., S.K., J.L., H.J., X.P., Y.S., Y.T., B.W., C.W., H.Y., Yongxing Zhang, Y.L., W.S., Yanting Zhang, S.Z., S.W., Y.X., M.X).
  • Ge S; Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Li Zhang, D.Z., J.W., C.Z., H.L., X.X., S.K., J.L., H.J., X.P., Y.S., Y.T., B.W., C.W., H.Y., Yongxing Zhang, Y.L., W.S., Yanting Zhang, S.Z., S.W., Y.X., M.X.).
  • Zhang L; Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China (Li Zhang, D.Z., J.W., C.Z., H.L., X.X., S.K., J.L., H.J., X.P., Y.S., Y.T., B.W., C.W., H.Y., Yongxing Zhang, Y.L., W.S., Yanting Zhang, S.Z., S.W., Y.X., M.X).
  • Hu Y; Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Li Zhang, D.Z., J.W., C.Z., H.L., X.X., S.K., J.L., H.J., X.P., Y.S., Y.T., B.W., C.W., H.Y., Yongxing Zhang, Y.L., W.S., Yanting Zhang, S.Z., S.W., Y.X., M.X.).
  • Xie M; Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China (Li Zhang, D.Z., J.W., C.Z., H.L., X.X., S.K., J.L., H.J., X.P., Y.S., Y.T., B.W., C.W., H.Y., Yongxing Zhang, Y.L., W.S., Yanting Zhang, S.Z., S.W., Y.X., M.X).
Circulation ; 142(2): 114-128, 2020 07 14.
Article em En | MEDLINE | ID: mdl-32421381
ABSTRACT

BACKGROUND:

To investigate deep vein thrombosis (DVT) in hospitalized patients with coronavirus disease 2019 (COVID-19), we performed a single institutional study to evaluate its prevalence, risk factors, prognosis, and potential thromboprophylaxis strategies in a large referral and treatment center.

METHODS:

We studied a total of 143 patients with COVID-19 from January 29, 2020 to February 29, 2020. Demographic and clinical data, laboratory data, including ultrasound scans of the lower extremities, and outcome variables were obtained, and comparisons were made between groups with and without DVT.

RESULTS:

Of the 143 patients hospitalized with COVID-19 (age 63±14 years, 74 [51.7%] men), 66 patients developed lower extremity DVT (46.1% 23 [34.8%] with proximal DVT and 43 [65.2%] with distal DVT). Compared with patients who did not have DVT, patients with DVT were older and had a lower oxygenation index, a higher rate of cardiac injury, and worse prognosis, including an increased proportion of deaths (23 [34.8%] versus 9 [11.7%]; P=0.001) and a decreased proportion of patients discharged (32 [48.5%] versus 60 [77.9%]; P<0.001). Multivariant analysis showed an association only between CURB-65 (confusion status, urea, respiratory rate, and blood pressure) score 3 to 5 (odds ratio, 6.122; P=0.031), Padua prediction score ≥4 (odds ratio, 4.016; P=0.04), D-dimer >1.0 µg/mL (odds ratio, 5.818; P<0.014), and DVT in this cohort, respectively. The combination of a CURB-65 score 3 to 5, a Padua prediction score ≥4, and D-dimer >1.0 µg/mL has a sensitivity of 88.52% and a specificity of 61.43% for screening for DVT. In the subgroup of patients with a Padua prediction score ≥4 and whose ultrasound scans were performed >72 hours after admission, DVT was present in 18 (34.0%) patients in the subgroup receiving venous thromboembolism prophylaxis versus 35 (66.0%) patients in the nonprophylaxis group (P=0.010).

CONCLUSIONS:

The prevalence of DVT is high and is associated with adverse outcomes in hospitalized patients with COVID-19. Prophylaxis for venous thromboembolism may be protective in patients with a Padua protection score ≥4 after admission. Our data seem to suggest that COVID-19 is probably an additional risk factor for DVT in hospitalized patients.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pneumonia Viral / Infecções por Coronavirus / Trombose Venosa País/Região como assunto: Asia Idioma: En Revista: Circulation Ano de publicação: 2020 Tipo de documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pneumonia Viral / Infecções por Coronavirus / Trombose Venosa País/Região como assunto: Asia Idioma: En Revista: Circulation Ano de publicação: 2020 Tipo de documento: Article