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    High prevalence SERO of deep venous thrombosis HP deep venous thrombosis MESHD in non-severe COVID-19 patients hospitalized for a neurovascular disease MESHD

    Authors: Olivier Rouyer; Irene-Nora Pierre-Paul; Amadou Balde; Damaris Jupitet; Daniela Bindila; Bernard Geny; Valerie Wolff

    doi:10.1101/2020.09.03.20187344 Date: 2020-09-05 Source: medRxiv

    Abstract Introduction: Severe SARS-CoV-2 infection MESHD, responsible for COVID-19, is accompanied by venous thromboembolic MESHD events particularly in intensive care unit. In non-severe COVID-19 patients affected by neurovascular diseases MESHD, the prevalence SERO of deep venous thrombosis HP deep venous thrombosis MESHD ( DVT MESHD) is unknown. The aim of or study was to report data obtained after systematic Doppler ultrasound scanning ( DUS MESHD) of lower limbs in such patients. Methods: Between March 20 and May 2, 2020, consecutive patients with neurovascular diseases MESHD with non-severe COVID-19 were investigated with a systematic bedside DUS. Results Thirteen patients were enrolled including 10 acute ischemic strokes MESHD ischemic strokes HP, one transient ischemic attack HP ischemic MESHD attack, one cerebral venous thrombosis HP cerebral venous thrombosis MESHD and one haemorrhagic stroke MESHD stroke HP. At admission, the median National Institute of Health Stroke HP Stroke MESHD Scale (NIHSS) was of 6 (IQR, 0-20). We found a prevalence SERO of 38.5% of asymptomatic TRANS calves DVT MESHD (n=5) during the first week after admission despite thromboprophylaxis. Among them, one patient had a symptomatic pulmonary embolism HP pulmonary embolism MESHD. Two patients died during hospitalization but the outcome was favourable in the others with a discharge median NIHSS of 1 (IQR, 0-11). Discussion/Conclusion: Despite thromboprophylaxis, systematic bedside DUS showed a high prevalence SERO of 38.5% of DVT MESHD in non-severe COVID-19 patients with neurovascular diseases MESHD. Therefore, we suggest that this non-invasive investigation should be performed in all patients of this category.

    Comparative analysis of immune-associated genes in COVID-19, cardiomyopathy HP cardiomyopathy MESHD and venous thromboembolism MESHD thromboembolism HP

    Authors: Grant E Castaneda; Abby C Lee; Wei Tse Li; Chengyu Chen; Jaideep Chakladar; Eric Chang; Weg Ongkeko; Xiaojian Liu; Wei Gao; Renli Zhang; Qiru Su; Andrew Azman; Justin Lessler; Xuan Zou; Wenfeng Gong; Brenda Clemente; Jerel Vega; Scott Roberts; Jose A. Gonzalez; Marciano Sablad; Rodrigo Yelin; Wendy Taylor; Kiyoshi Tachikawa; Suezanne Parker; Priya Karmali; Jared Davis; Sean M Sullivan; Steve G. Hughes; Pad Chivukula; Eng Eong Ooi

    doi:10.1101/2020.08.28.20184234 Date: 2020-09-02 Source: medRxiv

    As of 28 August 2020, there have been 5.88 million Coronavirus Disease MESHD 2019 (COVID-19) cases and 181,000 COVID-19 related deaths in the United States alone. Given the lack of an effective pharmaceutical treatment for COVID-19, the high contagiousness of the disease and its varied clinical outcomes, identifying patients at risk of progressing to severe disease is crucial for the allocation of valuable healthcare resources during this pandemic. Current research has shown that there is a higher prevalence SERO of cardiovascular comorbidities amongst patients with severe COVID-19 or COVID-19-related deaths, but the link between cardiovascular disease MESHD and poorer prognosis is poorly understood. We believe that pre-existing immune dysregulation HP that accompanies cardiovascular disease MESHD predisposes patients to a harmful inflammatory immune response, leading to their higher risk of severe disease. Thus, in this project, we aim to characterize immune dysregulation HP dysregulation MESHD in patients with cardiomyopathy HP cardiomyopathy MESHD, venous thromboembolism MESHD thromboembolism HP and COVID-19 patients by looking at immune-associated gene dysregulation, immune HP infiltration and dysregulated immunological pathways and gene signatures.

    Epidemiology of Venous Thromboembolism MESHD Thromboembolism HP in SARS- CoV-2 Infected MESHD Patients: A Systematic Review and Meta-Analysis

    Authors: Souvik Maitra; Dalim Kumar Baidya; Sulagna Bhattacharjee; Rahul Kumar Anand; Bikash Ranjan Ray; A. Christine Argento; Michelle H. Prickett; - NU COVID Investigators; Richard G. Wunderink; Sean B. Smith; Samira Mubareka; Allison McGeer; Adrienne K Chan; Anne-Claude Gingras; Tania H Watts; Mario Ostrowski; Elisabet Leiva; Albert Ariza-Sole; Paolo D Dallaglio; Maria Quero; Antonio Soriano; Alberto Pasqualetto; Maylin Koo; Virginia Esteve; Arnau Antoli; Rafael Moreno; Sergi Yun; Pau Cerda; Mariona Llaberia; Francesc Formiga; Marta Fanlo; Abelardo Montero; David Chivite; Olga Capdevila; Ferran Bolao; Xavier Pinto; Josep Llop; Antoni Sabate; Jordi Guardiola; Josep M Cruzado; Josep Comin-Colet; Salud Santos; Ramon Jodar; Xavier Corbella

    doi:10.1101/2020.08.28.20184028 Date: 2020-09-01 Source: medRxiv

    Early reports from China and Europe indicated that incidence of venous thromboembolism MESHD thromboembolism HP in COVID-19 patients may be high. In this meta-analysis of observational studies was designed to know worldwide prevalence SERO of thromboembolic MESHD events in COVID-19 patients. Primary outcome of our review was to assess the proportion of patients with VTE MESHD. Secondary outcomes were to assess the proportion of patients with DVT and proportion of patients with PE. Random effect meta-analysis model with restricted maximum likelihood estimator was used for all analysis. Pooled proportion with 95% confidence interval (95% CI) and heterogeneity (I2) was reported for all outcomes. Data of 5426 patients from n=19 articles were included in this systematic review and meta-analysis. Incidence of VTE MESHD (95% CI), PE (95% CI) and DVT (95% CI) was 23 (10- 36) %, 12 (6- 17) % and 15 (8- 23) %. We have found a high but incidence of thromboembolic MESHD events in COVID-19 patients. Further well-designed studies are required in this area to identify true incidence and risk factors of it.

    Severity-stratified and longitudinal analysis of VWF/ADAMTS13 imbalance, altered fibrin crosslinking and inhibition of fibrinolysis as contributors to COVID-19 coagulopathy MESHD

    Authors: Kieron South; Lucy Roberts; Lucy Victoria Morris; Elizabeth Mann; Madhvi Menon; Sean Knight; Joanne E Konkel; Andrew Ustianowsk; Nawar D Bakerly; Paul M Dark; Angela Simpson; Timothy Felton; Alexander Horsley; - CIRCO; Tracy Hussell; John R. Grainger; Craig J Smith; Stuart M Allan; Michelle M. Lister; Hannah C. Howson-Wells; Edward C Holmes; Matthew W. Loose; Jonathan K. Ball; C. Patrick McClure; - The COVID-19 Genomics UK consortium study group; Shi Chen

    doi:10.1101/2020.08.18.20159608 Date: 2020-08-21 Source: medRxiv

    Background: Early clinical reports have suggested that the prevalence SERO of thrombotic complications MESHD in the pathogenesis of COVID-19 may be as high as 30% in intensive care unit (ICU)-admitted patients and could be a major factor contributing to mortality. However, mechanisms underlying COVID-19-associated thrombo-coagulopathy MESHD, and its impact on patient morbidity and mortality, are still poorly understood. Methods: We performed a comprehensive analysis of coagulation and thromboinflammatory factors in plasma SERO from COVID-19 patients with varying degrees of disease severity. Furthermore, we assessed the functional impact of these factors on clot formation and clot lysis. Results: Across all COVID-19 disease severities (mild, moderate and severe) we observed a significant increase (6-fold) in the concentration of ultra-large von Willebrand MESHD factor (UL-VWF) multimers compared to healthy controls. This is likely the result of an interleukin (IL)-6 driven imbalance of VWF and the regulatory protease ADAMTS13 (a disintegrin and metalloproteinase with thrombospondin type 1 motifs, member 13). Upregulation of this key pro-coagulant pathway may also be influenced by the observed increase (~6-fold) in plasma SERO -defensins, a consequence of increased numbers of neutrophils and neutrophil activation. Markers of endothelial, platelet and leukocyte activation were accompanied by increased plasma SERO concentrations of Factor XIII (FXIII) and plasminogen activator inhibitor (PAI)-1. In patients with high FXIII we observed alteration of the fibrin network structure in in vitro assays of clot formation, which coupled with increased PAI-1, prolonged the time to clot lysis by the t-PA/plasmin fibrinolytic pathway by 52% across all COVID-19 patients (n=23). Conclusions: We show that an imbalance in the VWF/ADAMTS13 axis causing increased VWF reactivity may contribute to the formation of platelet-rich thrombi in the pulmonary vasculature of COVID-19 patients. Through immune and inflammatory responses, COVID-19 also alters the balance of factors involved in fibrin generation and fibrinolysis which accounts for the persistent fibrin deposition previously observed in post-mortem lung tissue.

    High Incidence of Venous Thromboembolism MESHD Thromboembolism HP in Patients with Coronavirus Disease MESHD 2019: A Call for Improved Awareness and Prevention

    Authors: Yun-xia Zhang; Meng Zhang; Yimin Wang; Wei Qin; Zhu Zhang; Chenghong Li; Zhenguo Zhai

    doi:10.21203/rs.3.rs-60522/v1 Date: 2020-08-16 Source: ResearchSquare

    Background: An increased risk of venous thromboembolism MESHD thromboembolism HP ( VTE MESHD) in patients with coronavirus disease MESHD 2019 (COVID-19) has been reported. We performed a meta-analysis to evaluate the prevalence SERO of VTE MESHD in COVID-19 patients.Methods: The PubMed and Embase databases were searched for studies reporting VTE MESHD in COVID-19 patients up to June 27, 2020. The selected studies were predefined into the “suspected screening group” and the “routine screening group.” The VTE MESHD prevalence SERO was calculated using random-effect models.Results: We selected 20 studies including a total of 2763 COVID-19 patients. In 2203 COVID-19 patients from the suspected screening group, the pool VTE MESHD incidence was 15.2% (95% confidence interval [CI]: 10.5–21.6%). In 560 COVID-19 patients from the routine screening group, the VTE MESHD prevalence SERO was 40.8% (95% CI: 20.6–64.7%). Furthermore, the VTE MESHD incidence of critically ill COVID-19 patients from the two groups was 19.6% and 61.4%, respectively, which indicates that critically ill COVID-19 patients were more susceptible to VTE MESHD.Conclusions: A high incidence of VTE MESHD was observed in COVID-19 patients, especially in severe cases. The incidence of VTE MESHD in COVID-19 patients from the routine screening group was higher than that in patients from the suspected screening group. This indicates that a lower threshold of suspicion to perform VTE MESHD imaging tests may be reasonable and there is an urgent need to adapt a regular screening strategy for VTE MESHD.

    Deep Venous Thrombosis HP Deep Venous Thrombosis MESHD in COVID-19 Patients: A Cohort Analysis

    Authors: Yi Guo; Yun You; Ke Hu; Fei Cai; Yiqing Li; Mingxing Xie; Lu Yang; Dawei Ye; Ken Ling; Sanjay Misra; Weici Wang; chuanqi cai

    doi:10.21203/rs.3.rs-39414/v1 Date: 2020-07-01 Source: ResearchSquare

    BackgroundDeep venous thrombosis HP venous thrombosis MESHD (DVT) is a severe complication of the coronavirus disease MESHD 2019 (COVID-19). It may interfere with COVID-19 treatment and delay the recovery, but there is less data about the anticoagulant therapy and sex difference of VTE MESHD in patients with COVID-19. The purpose of this study is to study the prevalence SERO, risk factors, anticoagulant therapy and sex difference of deep venous thrombosis HP deep venous thrombosis MESHD ( DVT MESHD) in patients with COVID-19.MethodsThe enrolled 121 patients were confirmed positive for COVID-19. All suspected patients with a high Caprini index (≥4) or PADUA index (≥4) received color Doppler Ultrasound (US) to screen DVT MESHD in both lower extremities. Clinical characteristics of DVT MESHD-COVID-19 patients were analyzed. Multivariate logistic regression was performed to identify risk factors related to DVT MESHD in COVID-19 patients. The distribution of DVT MESHD locations, anticoagulation therapy with sex difference, and the outcomes were also analyzed.ResultsDVT was found in 48% asymptomatic TRANS COVID-19 patients with increased PAUDA index or Caprini index by US scanning. Multivariate logistic regression determined that age TRANS, CRP and baseline D-dimer were risk factors among COVDI-19 patients. Although the most common DVT MESHD location was infrapopliteal (Class I and Class II), higher mortality in DVT MESHD-COVID-19 patients was confirmed. DVT MESHD-COVID-19 patients presented significant increases in the CRP, neutrophil count and D-dimer throughout the whole inpatient period compared to non- DVT MESHD-COVID-19 patients. Although anticoagulation therapy accelerated the recovery of lymphocytopenia condition MESHD in DVT MESHD patients, men DVT MESHD-COVID-19 patients showed higher CRP and neutrophil count vs. lymphocyte count (N/L) ratio but lower lymphocyte count compared to women DVT MESHD-COVID-19 patients. ConclusionsDVT is common in COVID-19 patients with high risk factors, especially for older age TRANS, higher CRP and baseline D-dimer populations. It is important to consider sex differences in the anticoagulant therapy among DVT MESHD-COVID-19 patients.

    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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