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Overview

MeSH Disease

Human Phenotype

Transmission

Seroprevalence
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    D-dimers at hospital admission for COVID-19 are associated with in hospital mortality independently of venous thromboembolism MESHD thromboembolism HP: Insight from a French multicenter cohort study

    Authors: Richard Chocron; Baptiste Duceau; Nicolas Gendron; Nacim Ezzouhairi; Lina Khider; Antonin Trimaille; Guillaume Goudot; Orianne Weizman; Jean Marc Alsac; Thibault Pommier; Olivier Bory; Joffrey Cellier; Aurélien Philippe; Laura Geneste; Iannis Ben Abdallah; Vassili Panagides; Salma El Batti; Wassima Marsou; Philippe Juvin; Antoine Deney; Emmanuel Messas; Sabir Attou; Benjamin Planquette; Delphine Mika; Pascale Gaussem; Charles Fauvel; Jean-Luc Diehl; Theo Pezel; Tristan Mirault; Willy Sutter; Olivier Sanchez; Guillaume Bonnet; Ariel Cohen; David M. Smadja

    doi:10.21203/rs.3.rs-62363/v1 Date: 2020-08-19 Source: ResearchSquare

    Background: Coronavirus disease 2019 (COVID-19) has been associated with coagulation disorders MESHD, in particular high levels of D-dimers, and increased frequency of venous thromboembolism MESHD thromboembolism HP ( VTE MESHD). We explore the association between D-dimers at admission and in-hospital mortality in hospitalized COVID-19 patients with or without symptomatic VTE MESHD.Methods: From February 26 to April 20, 2020, D-dimer level at admission and outcomes of patients hospitalized for COVID-19 in medical wards (in-hospital mortality or VTE MESHD) were retrospectively analyzed in a multicenter study in 24 French hospitals.Results: Among 2878 patients enrolled in the study, 1154 (40.9%) patients had D-dimer measurement at admission. A receiver operating characteristic (ROC) curve analysis identified D-dimer level above 1128 ng/mL as the optimum cutoff value to predict in-hospital mortality (Area Under the Curve of 64.9% (95% CI 0.60–0.69) with a sensitivity SERO of 71.1% (95% CI 0.62–0.78) and a specificity of 55.6% (95% CI 0.52–0.58) that not differ in the subgroup of patients with VTE during hospitalization. Among 609 (52.8%) patients with D-dimers level < 1128 ng/mL at admission, only 35 (5.7%) deaths occurred during hospitalization. After adjustment, in a cox proportional hazard and logistic regression models, D-dimers above 1128 ng/mL at admission were also associated to a worth prognosis with a OR of 3.07 (95% CI 2.05–4.69, p < 0.001) and an unadjusted hazard ratio of 2.11 (95%CI 1.31–3.4, p < 0.01).Conclusions: D-dimer level over 1128 ng/mL is a relevant predictive factor for in-hospital mortality in COVID-19 hospitalized patients in medical ward, regardless the occurrence of VTE during hospitalization.

    Association of D-dimer and fibrinogen magnitude with hypercoagulability HP hypercoagulability MESHD by thromboelastography in severe COVID-19

    Authors: Abhimanyu Chandel; Saloni Patolia; Mary Looby; Heidi Dalton; Najeebah Bade; Vikramjit Khangoora; Mehul Desai; James Lantry; Erik Osborn; Svetolik Djurkovic; Daniel Tang; Steven D Nathan; Christopher S King

    doi:10.1101/2020.07.27.20162842 Date: 2020-07-29 Source: medRxiv

    Introduction: D-dimer concentration has been used to identify candidates for intensified anticoagulant treatment for both venous thromboembolism MESHD thromboembolism HP prevention and mitigation of the microthrombotic complications MESHD associated with COVID-19. Thromboelastography (TEG) maximum amplitude (MA) has been validated as an indicator of hypercoagulability HP hypercoagulability MESHD and MA [≥] 68 mm has been utilized as a marker of hypercoagulability HP hypercoagulability MESHD in other conditions. We evaluated the relationship between coagulation, inflammatory, and TEG parameters in patients with COVID-19 on extracorporeal membrane oxygenation (ECMO). Methods: We performed a single center retrospective analysis of consecutive patients that received ECMO for the treatment of COVID-19. TEG, inflammatory, and coagulation markers were compared in patients with and without thrombotic complications MESHD. Correlation tests were performed to identify the coagulation and inflammatory markers that best predict hypercoagulability HP hypercoagulability MESHD as defined by an elevated TEG MA. Results: 168 TEGs were available in 24 patients. C-reactive protein and fibrinogen were significantly higher in patients that developed a thrombotic MESHD event versus those that did not (p=0.038 and p=0.043 respectively). D-dimer was negatively correlated with TEG MA (p<0.001) while fibrinogen was positively correlated (p<0.001). A fibrinogen > 441 mg/dL had a sensitivity SERO of 91.2% and specificity of 85.7% for the detection of MA [≥] 68 mm. Conclusions: In critically ill MESHD patients with COVID-19, D-dimer concentration had an inverse relationship with hypercoagulability HP hypercoagulability MESHD as measured by TEG MA. D-dimer elevation may reflect severity of COVID-19 related sepsis HP sepsis MESHD rather than designate patients likely to benefit from anticoagulation. Fibrinogen concentration may represent a more useful marker of hypercoagulability HP hypercoagulability MESHD in this population.

    Clinical Characteristics and Outcomes of Venous Thromboembolism MESHD Thromboembolism HP in Patients Hospitalized for COVID-19: Systematic Review and Meta-Analysis

    Authors: Joshua Henrina; Iwan Cahyo Santosa Putra; Irvan Cahyadi; Hoo Felicia Hadi Gunawan; Alius Cahyadi; Leonardo Paskah Suciadi

    doi:10.1101/2020.06.14.20130922 Date: 2020-06-16 Source: medRxiv

    Objective: To investigate the clinical characteristics and outcomes of Coronavirus Disease MESHD of 2019 (COVID-19) patients complicated with venous thromboembolism MESHD thromboembolism HP ( VTE MESHD) Method: We performed a comprehensive literature search of several databases to find studies that assessed VTE MESHD in hospitalized COVID-19 patients with a primary outcome of all-cause mortality and secondary outcomes of intensive care unit (ICU) admission and mechanical ventilation. We also evaluated the clinical characteristics of VTE MESHD sufferers. Objective: To investigate the clinical characteristics and outcomes of Coronavirus Disease MESHD of 2019 (COVID-19) patients complicated with venous thromboembolism MESHD thromboembolism HP ( VTE MESHD) Method: We performed a comprehensive literature search of several databases to find studies that assessed VTE MESHD in hospitalized COVID-19 patients with a primary outcome of all-cause mortality and secondary outcomes of intensive care unit (ICU) admission and mechanical ventilation. We also evaluated the clinical characteristics of VTE MESHD sufferers. Results: Eight studies have been included with a total of 1237 pooled subjects. Venous thromboembolism MESHD thromboembolism HP was associated with higher mortality (RR 2.48 (1.35, 4.55), p=0.003; I2 5%, p=0.35) after we performed sensitivity SERO analysis, ICU admission (RR 2.32 (1.53, 3.52), p<0.0001; I2 80%, p <0.0001), and mechanical ventilation need (RR 2.73 (1.56, 4.78), p=0.0004; I2 77%, p=0.001). Furthermore, it was also associated to male TRANS gender TRANS (RR 1.21 (1.08, 1.35), p=0.0007; I2 12%, p=0.34), higher white blood SERO cells count (MD 1.24 (0.08, 2.41), 0.04; I2 0%; 0.26), D-dimer (MD 4.49 (2.74, 6.25), p<0.00001; I2 67%, p=0.009) and LDH levels (MD 70.93 (19.33, 122.54), p<0.007; I2 21%, p=0.28). In addition, after sensitivity SERO analysis was conducted, VTE MESHD also associated with older age TRANS ( MD MESHD 2.79 (0.06, 5.53), p=0.05; I2 25%, p=0.24) and higher CRP levels (MD 2.57 (0.88, 4.26); p=0.003; I2 0%, p=0.96). Conclusion: Venous thromboembolism MESHD thromboembolism HP in COVID-19 patients was associated with increased mortality, ICU admission, and mechanical ventilation requirement. Male TRANS gender TRANS, older age TRANS, higher levels of biomarkers, including WBC count, D-Dimer, and LDH were also being considerably risks for developing VTE MESHD in COVID-19 patients during hospitalization. Conclusion: Venous thromboembolism MESHD thromboembolism HP in COVID-19 patients was associated with increased mortality, ICU admission, and mechanical ventilation requirement. Male TRANS gender TRANS, older age TRANS, higher levels of biomarkers, including WBC count, D-Dimer, and LDH were also being considerably risks for developing VTE MESHD in COVID-19 patients during hospitalization.

    High Incidence of Venous Thrombosis HP Venous Thrombosis MESHD in Patients with Moderate to Severe COVID-19

    Authors: Oleg B Kerbikov; Pavel Yu Orekhov; Ekaterina N Borskaya; Natalia S Nosenko

    doi:10.1101/2020.06.12.20129536 Date: 2020-06-14 Source: medRxiv

    COVID-19 predisposes to venous thromboembolism MESHD thromboembolism HP and there are multiple data regarding high incidence of venous thrombosis HP venous thrombosis MESHD in critical COVID-19 patients, however reports on this complication in less severe patients are not widely available. The aim of this study was to investigate the incidence of deep-vein thrombosis MESHD ( DVT MESHD) in patients with moderate to severe COVID-19 and to assess the prevalence SERO of DVT MESHD with lung computerized tomography (lung CT) exams, clinical information and lab data. This study examined 75 consecutive patients with moderate to severe COVID-19, with specific exclusions. METHODS Almost all patients (pts) admitted to our hospital in the first half of May underwent comprehensive vein ultrasonography. 75 pts ( aged TRANS 27-92 y, median - 63 y, 36 males TRANS and 39 females TRANS) with moderate to severe COVID-19 were included in our study. RESULTS Spontaneous echo contrast (decreased blood SERO velocity and blood SERO stasis) was detected in common femoral veins in 53 pts (70.7%). DVT MESHD was found in 15 pts (20%). The vast majority of those with DVT MESHD (13 pts, 86.7%) had thrombi only in calf veins and ileofemoral thrombosis MESHD was detected in 2 pts with DVT MESHD (13.3%). There was no significant observed difference between DVT MESHD and non- DVT MESHD patients with respect to age TRANS, underlying diseases, lung CT scores and SpaO2 at admission. There was also no significant observed difference between DVT MESHD and non- DVT MESHD patients with respect to both "time from symptoms onset TRANS to admission" and with respect to the majority of lab data. However, a significant difference was observed in D-dimer level (1.87 +/- 1.62 vs 0.51 +/- 0,4 mcg/mL p<0.0001) and C-reactive protein (116.9 +/- 83,6 and 65.1 +/- 64.98 mg/L, p = 0.014) for patients with DVT MESHD and patients without DVT MESHD respectably (Receiver operating characteristics (ROC) curve analysis revealed that the level of D-dimer >/= 0.69 mcg/mL is the predictor of DVT MESHD with a sensitivity SERO of 76.9%, a specificity of 77.6%, p < 0.001 (AUC area under curve = 0.7944). Logistic regression confirmed that D-dimer is an independent predictor of DVT MESHD and patients with D-dimer >/= 0.69 mcg/mL have odds ratio (OR) of developing DVT MESHD = 5.1 (confidence interval [CI] 1.9 - 13.5)). CONCLUSION Patients with moderate to severe COVID-19 show high incidence of DVT MESHD, indicating that moderate to severe COVID-19 patients may require an early administration of anticoagulation therapy as part of their treatment. Such therapy may be continued after hospital discharge. Based on these findings, these patients may also require a follow-up with vein ultrasonography after recovery to rule out DVT MESHD.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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