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Eur Rev Med Pharmacol Sci ; 25(4): 2123-2130, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33660832

RESUMO

OBJECTIVE: Diffuse thrombosis represents one of the most predominant causes of death by COVID-19 and SARS-CoV-2 infection seems to increase the risk of developing venous thromboembolic diseases (VTE). Aim of this study is to analyze the relationship between validated predictive scores for VTE such as IMPROVE and IMPROVEDD and: (1) Intensification of Care (IoC, admission to Pulmonology Department or Intensive Care Unit) (2) in-hospital mortality rate 3) 30-days mortality rate. PATIENTS AND METHODS: We retrospectively evaluated 51 adult patients with laboratory diagnosis of SARS-CoV-2 infection and calculated IMPROVE and IMPROVEDD scores. All patients underwent venous color-Doppler ultrasound of the lower limbs to assess the presence of superficial vein thrombosis (SVT) and/or deep vein thrombosis (DVT). Patients with normal values of D-dimer did not receive heparin therapy (LMWH); patients with ≥ 4 ULN values of D-dimer or with a diagnosis of DVT were treated with therapeutic LMWH dosage, while the remaining patients were treated with prophylactic LMWH dosages. RESULTS: We found strong relations between IMPROVE score and the need for IoC and with the in-hospital mortality rate and between the IMPROVEDD score and the need for IoC. We defined that an IMPROVE score greater than 4 points was significantly associated to in-hospital mortality rate (p = 0.05), while an IMPROVEDD score greater than 3 points was associated with the need for IoC (p = 0.04). Multivariate logistic analysis showed how IMPROVE score was significantly associated to in-hospital and 30-days mortality rates. CONCLUSIONS: IMPROVE score can be considered an independent predictor of in-hospital and 30-days mortality.


Assuntos
COVID-19/complicações , Fibrinolíticos/uso terapêutico , Heparina de Baixo Peso Molecular/uso terapêutico , SARS-CoV-2 , Trombose Venosa/prevenção & controle , Adulto , COVID-19/sangue , COVID-19/diagnóstico por imagem , COVID-19/mortalidade , Cuidados Críticos/estatística & dados numéricos , Intervalo Livre de Doença , Produtos de Degradação da Fibrina e do Fibrinogênio/análise , Fibrinolíticos/administração & dosagem , Heparina de Baixo Peso Molecular/administração & dosagem , Humanos , Itália , Modelos Logísticos , Extremidade Inferior/diagnóstico por imagem , Análise Multivariada , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Ultrassonografia Doppler Dupla , Trombose Venosa/diagnóstico por imagem , Trombose Venosa/etiologia , Trombose Venosa/mortalidade
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