Incidence, risk factors, clinical characteristics and outcomes of deep venous thrombosis in patients with COVID-19 attending the Emergency Department: results of the UMC-19-S8.
Eur J Emerg Med
; 28(3): 218-226, 2021 Jun 01.
Article
en En
| MEDLINE
| ID: mdl-33904528
ABSTRACT
BACKGROUND AND IMPORTANCE A higher incidence of venous thromboembolism [both pulmonary embolism and deep vein thrombosis (DVT)] in patients with coronavirus disease 2019 (COVID-19) has been described. But little is known about the true frequency of DVT in patients who attend emergency department (ED) and are diagnosed with COVID-19. OBJECTIVE:
We investigated the incidence, risk factors, clinical characteristics and outcomes of DVT in patients with COVID-19 attending the ED before hospitalization.METHODS:
We retrospectively reviewed all COVID patients diagnosed with DVT in 62 Spanish EDs (20% of Spanish EDs, case group) during the first 2 months of the COVID-19 outbreak. We compared DVT-COVID-19 patients with COVID-19 without DVT patients (control group). Relative frequencies of DVT were estimated in COVID and non-COVID patients visiting the ED and annual standardized incidences were estimated for both populations. Sixty-three patient characteristics and four outcomes were compared between cases and controls.RESULTS:
We identified 112 DVT in 74 814 patients with COVID-19 attending the ED [1.50; 95% confidence interval (CI), 1.23-1.80]. This relative frequency was similar than that observed in non-COVID patients [2109/1 388 879; 1.52; 95% CI, 1.45-1.69; odds ratio (OR) = 0.98 [0.82-1.19]. Standardized incidence of DVT was higher in COVID patients (98,38 versus 42,93/100,000/year; OR, 2.20; 95% CI, 2.03-2.38). In COVID patients, the clinical characteristics associated with a higher risk of presenting DVT were older age and having a history of venous thromboembolism, recent surgery/immobilization and hypertension; chest pain and desaturation at ED arrival and some analytical disturbances were also more frequently seen, d-dimer >5000 ng/mL being the strongest. After adjustment for age and sex, hospitalization, ICU admission and prolonged hospitalization were more frequent in cases than controls, whereas mortality was similar (OR, 1.37; 95% CI, 0.77-2.45).CONCLUSIONS:
DVT was an unusual form of COVID presentation in COVID patients but was associated with a worse prognosis.
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Tromboembolia Venosa
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COVID-19
Tipo de estudio:
Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
Eur J Emerg Med
Asunto de la revista:
MEDICINA DE EMERGENCIA
Año:
2021
Tipo del documento:
Article