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Rate of venous thromboembolism in a prospective all-comers cohort with COVID-19.
J Thromb Thrombolysis. 2020 Oct; 50(3):558-566.JT

Abstract

COVID-19 is associated with a variety of clinical complications including coagulopathy, which frequently results in venous thromboembolism (VTE). Retrospective analyses reported a markedly increased rate of VTEs in COVID-19. However, most recent studies on coagulopathy in COVID-19 were only focused on critically ill patients, and without suitable control groups. We aimed to evaluate the rate of VTEs in an all-comers cohort with suspected COVID-19 during a 30-days follow-up period. We also studied the level of D-dimers and their association with the course of disease. In our prospective single-center study (DRKS00021206, 03/30/2020), we analyzed 190 patients with suspected COVID-19 admitted to the emergency department between March and April 2020. Forty-nine patients were SARS-CoV-2 positive (25.8%). The 141 SARS-CoV-2-negative patients served as control group. After completion of a 30-days follow-up, VTE was diagnosed in 3 patients of the SARS-CoV-2-positive group (6.1%, amongst these 2 ICU cases) versus 5 patients in the SARS-CoV-2-negative group (3.5%), however the difference was not statistically significant (p = 0.427). 30-days mortality was similar in both groups (6.1% vs. 5%, p = 0.720). Disease severity correlated with the maximum level of D-dimers during follow-up in COVID-19. The rate of VTE was numerically higher in SARS-CoV-2 positive all-comers presenting with suspected COVID-19 as compared to well-matched controls suffering from similar symptoms. VTEs in the COVID-19 group predominantly occurred in ICU courses. The maximum level of D-dimers during follow-up was associated with disease severity in COVID-19, whereas the level of D-dimers at admission was not.

Authors+Show Affiliations

Department of Medicine III (Interdisciplinary Medical Intensive Care), Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany. marina.baeuml@universitaets-herzzentrum.de. Department of Cardiology and Angiology I, Heart Center, University of Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany. marina.baeuml@universitaets-herzzentrum.de.Department of Medicine III (Interdisciplinary Medical Intensive Care), Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany. Department of Cardiology and Angiology I, Heart Center, University of Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany.Department of Medicine III (Interdisciplinary Medical Intensive Care), Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany. Department of Cardiology and Angiology I, Heart Center, University of Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany.Department of Medicine III (Interdisciplinary Medical Intensive Care), Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany. Department of Cardiology and Angiology I, Heart Center, University of Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany.Institute of Experimental and Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Freiburg, Freiburg, Germany.Institute of Experimental and Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Freiburg, Freiburg, Germany.Department of Medicine III (Interdisciplinary Medical Intensive Care), Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany. Department of Cardiology and Angiology I, Heart Center, University of Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany.Department of Medicine III (Interdisciplinary Medical Intensive Care), Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany. Department of Cardiology and Angiology I, Heart Center, University of Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany.Department of Emergency Medicine, Faculty of Medicine, University Hospital of Freiburg, University of Freiburg, Freiburg, Germany.Department of Emergency Medicine, Faculty of Medicine, University Hospital of Freiburg, University of Freiburg, Freiburg, Germany.Department of Medicine III (Interdisciplinary Medical Intensive Care), Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany. Department of Cardiology and Angiology I, Heart Center, University of Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany.Department of Medicine III (Interdisciplinary Medical Intensive Care), Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany. Department of Cardiology and Angiology I, Heart Center, University of Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany.Department of Medicine III (Interdisciplinary Medical Intensive Care), Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany. Department of Cardiology and Angiology I, Heart Center, University of Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany. Institute of Experimental and Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Freiburg, Freiburg, Germany.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32617807

Citation

Rieder, Marina, et al. "Rate of Venous Thromboembolism in a Prospective All-comers Cohort With COVID-19." Journal of Thrombosis and Thrombolysis, vol. 50, no. 3, 2020, pp. 558-566.
Rieder M, Goller I, Jeserich M, et al. Rate of venous thromboembolism in a prospective all-comers cohort with COVID-19. J Thromb Thrombolysis. 2020;50(3):558-566.
Rieder, M., Goller, I., Jeserich, M., Baldus, N., Pollmeier, L., Wirth, L., Supady, A., Bode, C., Busch, H. J., Schmid, B., Duerschmied, D., Gauchel, N., & Lother, A. (2020). Rate of venous thromboembolism in a prospective all-comers cohort with COVID-19. Journal of Thrombosis and Thrombolysis, 50(3), 558-566. https://doi.org/10.1007/s11239-020-02202-8
Rieder M, et al. Rate of Venous Thromboembolism in a Prospective All-comers Cohort With COVID-19. J Thromb Thrombolysis. 2020;50(3):558-566. PubMed PMID: 32617807.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rate of venous thromboembolism in a prospective all-comers cohort with COVID-19. AU - Rieder,Marina, AU - Goller,Isabella, AU - Jeserich,Maren, AU - Baldus,Niklas, AU - Pollmeier,Luisa, AU - Wirth,Luisa, AU - Supady,Alexander, AU - Bode,Christoph, AU - Busch,Hans-Jörg, AU - Schmid,Bonaventura, AU - Duerschmied,Daniel, AU - Gauchel,Nadine, AU - Lother,Achim, PY - 2020/7/4/pubmed PY - 2020/10/2/medline PY - 2020/7/4/entrez KW - COVID-19 KW - D-dimers KW - SARS-CoV-2 KW - Venous thromboembolism SP - 558 EP - 566 JF - Journal of thrombosis and thrombolysis JO - J Thromb Thrombolysis VL - 50 IS - 3 N2 - COVID-19 is associated with a variety of clinical complications including coagulopathy, which frequently results in venous thromboembolism (VTE). Retrospective analyses reported a markedly increased rate of VTEs in COVID-19. However, most recent studies on coagulopathy in COVID-19 were only focused on critically ill patients, and without suitable control groups. We aimed to evaluate the rate of VTEs in an all-comers cohort with suspected COVID-19 during a 30-days follow-up period. We also studied the level of D-dimers and their association with the course of disease. In our prospective single-center study (DRKS00021206, 03/30/2020), we analyzed 190 patients with suspected COVID-19 admitted to the emergency department between March and April 2020. Forty-nine patients were SARS-CoV-2 positive (25.8%). The 141 SARS-CoV-2-negative patients served as control group. After completion of a 30-days follow-up, VTE was diagnosed in 3 patients of the SARS-CoV-2-positive group (6.1%, amongst these 2 ICU cases) versus 5 patients in the SARS-CoV-2-negative group (3.5%), however the difference was not statistically significant (p = 0.427). 30-days mortality was similar in both groups (6.1% vs. 5%, p = 0.720). Disease severity correlated with the maximum level of D-dimers during follow-up in COVID-19. The rate of VTE was numerically higher in SARS-CoV-2 positive all-comers presenting with suspected COVID-19 as compared to well-matched controls suffering from similar symptoms. VTEs in the COVID-19 group predominantly occurred in ICU courses. The maximum level of D-dimers during follow-up was associated with disease severity in COVID-19, whereas the level of D-dimers at admission was not. SN - 1573-742X UR - https://www.unboundmedicine.com/medline/citation/32617807/Rate_of_venous_thromboembolism_in_a_prospective_all_comers_cohort_with_COVID_19_ L2 - https://doi.org/10.1007/s11239-020-02202-8 DB - PRIME DP - Unbound Medicine ER -