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Overview

MeSH Disease

Human Phenotype

Transmission

Seroprevalence
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    Acute pulmonary embolism HP pulmonary embolism MESHD in acutely ill COVID-19 patients admitted to internal medicine wards.

    Authors: Hernan POLO FRIZ; Elia GELFI; Annalisa ORENTI; Elena MOTTO; Laura PRIMITZ; Tino DONZELLI; Marcello INTOTERO; Paolo SCARPAZZA; Giuseppe VIGHI; Claudio CIMMINIELLO; Patrizia BORACCHI

    doi:10.21203/rs.3.rs-73601/v1 Date: 2020-09-07 Source: ResearchSquare

    INTRODUCTION. Emerging evidence linking COVID-19 to an increased risk of acute pulmonary embolism MESHD pulmonary embolism HP ( APE MESHD). The aim of the present study was to assess the prevalence SERO of APE MESHD in acutely ill COVID-19 patients admitted to internal medicine department wards and to investigate the association of clinical and biochemical variables with a confirmed diagnosis of APE MESHD. METHODS. All consecutive patients admitted to the internal medicine department wards of a general hospital with a diagnosis of severe COVID-19, who performed a Computer Tomography Pulmonary Angiography(CTPA) for respiratory deterioration MESHD in April 2020, were included. RESULTS. Study populations: 41 subjects, median(IRQ) age TRANS: 71.7(63-76) years, CPTA confirmed APE MESHD=8(19.51%,CI95%:8.82%-34.87%). Among patients with and without APE MESHD, no significant differences were found with regards symptoms, comorbidities, treatment, Wells score and outcomes. The optimal cut-off value of D-dimer for predicting APE MESHD was 2454 ng/mL, sensitivity SERO(CI95%):63(24-91), specificity:73(54-87), Positive Predictive Value SERO:36(13-65), Negative Predictive Value SERO: 89(71-98) and AUC:0.62(0.38-0.85). The standard and age TRANS-adjusted D-dimer cut-offs, and the Wells score > 2 did not associate with confirmed APE MESHD, albeit a cut-off value of D-dimer=2454 ng/mL showed an RR:3.21;CI95%:0.92-13.97;p = 0.073.CONCLUSION. In acutely ill COVID-19 patients admitted to internal medicine department wards who performed CTPA for respiratory deterioration MESHD, the prevalence SERO of APE MESHD was high, and the traditional diagnostic tools to identify high APE MESHD pre-test probability patients did not show to be clinically useful. These results support the use of a lower threshold of suspicion to perform CTPA for excluding or confirming APE MESHD as the most appropriate approach in this clinical setting.

    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.

    Prevalence SERO of Venous Thromboembolism HP in Critically-ill COVID-19 Patients: Systematic Review and Meta-analysis

    Authors: Mouhand F.H. Mohamed; Shaikha D. Al-Shokri; Khaled M. Shunnar; Sara F. Mohamed; Mostafa S. Najim; Shahd I. Ibrahim; Hazem Elewa; Khalid M. Dousa; Lina O. Abdalla; Ahmed El-Bardissy; Mohamed Nabil Elshafei; Ibrahim Y. Abubeker; Mohammed Danjuma; Mohamed A Yassin; Sharif A Ismail; Chengmin Shi; Zhenglin Du; Yadong Zhang; Chuandong Liu; Rujiao Li; Jingyao Zeng; Lili Hao; Shuai Jiang; Hua Chen; Dali Han; Jingfa Xiao; Zhang Zhang; Wenming Zhao; Yongbiao Xue; Yiming Bao; Valerie Mioulet; Joseph Newman; Amin S Asfor; Alison Burman; Sylvia Crossley; John Hammond; Elma Tchilian; Bryan Charleston; Dalan Bailey; Tobias J Tuthill; Simon Graham; Tomas Malinauskas; Jiandong Huo; Julia Tree; Karen Buttigieg; Ray Owens; Miles Carroll; Rod Daniels; John McCauley; Kuan-Ying A Huang; Mark Howarth; Alain Townsend

    doi:10.1101/2020.08.24.20175745 Date: 2020-08-29 Source: medRxiv

    Background: Recent studies revealed a high prevalence SERO of venous thromboembolism HP (VTE) events in coronavirus disease 2019 (COVID-19) patients, especially in those who are critically ill. Available studies report varying prevalence SERO rates. Hence, the exact prevalence SERO remains uncertain. Moreover, there is an ongoing debate regarding the appropriate dosage of thromboprophylaxis. Methods: We performed a systematic review and proportion meta-analysis following PRISMA guidelines. We searched PubMed and EMBASE for studies exploring the prevalence SERO of VTE in critically ill COVID-19 patients till 22/07/2020. We pooled the proportion of VTE. Additionally, in a subgroup analysis, we pooled VTE events detected by systematic screening. Finally, we compared the odds of VTE in patients on prophylactic compared to therapeutic anticoagulation. Results: The review comprised of 24 studies and over 2500 patients. The pooled proportion of VTE prevalence SERO was 0.31 (95% CI 0.24, 0.39 I2 94%), of VTE utilizing systematic screening was 0.48 (95% CI 0.33, 0.63 I2 91%), of deep-venous-thrombosis HP was 0.23 (95% CI 0.14, 0.32 I2 96%), of pulmonary embolism HP was 0.14 (95% CI 0.09, 0.20 I2 90%). In a subgroup of studies, utilizing systematic screening, VTE risk increased significantly with prophylactic, compared to therapeutic anticoagulation (OR 5.45; 95% CI 1.90, 15.57 I2 0%). Discussion: Our review revealed a high prevalence SERO of VTE in critically ill COVID-19 patients. Almost 50% of patients had VTE detected by systematic screening. Higher thromboprophylaxis dosages seem to reduce VTE burden in this patient's cohort compared to standard prophylactic anticoagulation; ongoing randomized controlled trials will further confirm this.

    Lesson by SARS-Cov 2 disease (COVID-19): whole body CT angiography detection of relevant and other/incidental systemic vascular findings

    Authors: Gaetano Rea; Francesco Lassandro; Roberta Lieto; Giorgio Bocchini; Federica Romano; Giacomo Sica; Tullio Valente; Emanuele Muto; Patrizia Murino; Antonio Pinto; Vincenzo Montesarchio; Maurizio Muto; Daniela Pacella; Ludovica Capitelli; Marialuisa Bocchino

    doi:10.21203/rs.3.rs-65060/v1 Date: 2020-08-24 Source: ResearchSquare

    Objectives: The aim of our study was to assess the frequency distribution of relevant and incidental vascular events in a retrospective cohort of 42 COVID-19 patients. Methods: All patients were studied by whole-body CT angiography.Twenty-three out of 42 patients were admitted to the intensive care unit (ICU). Results: Relevant vascular events were recorded in the 71.4% of the whole study population. Pulmonary embolism HP Pulmonary embolism MESHD was the most frequent one both in ICU and no-ICU cases (56.5% vs10.5%, p=0.002). Ischemic infarction MESHD of other organs was affecting with an increasing prevalence SERO the gut, the spleen, the liver, the brain and the kidney, with a simultaneous ischemic MESHD occurrence in some cases. Multi-focal venous thrombosis HP venous thrombosis MESHD was also represented especially in ICU patients (p=0.005). Among incidental findings, splanchnic vessels little-size aneurysms MESHD were reported in the 40% of the whole population, with relative frequencies similarly distributed in ICU and no-ICU patients.Conclusions: Vascular involvement is not negligible in COVID-19 and should be carefully investigated as may significantly affect disease behavior and prognosis.

    Rotational Thromboelastometry Predicts Care Level in COVID-19: A Prospective, Observational Study.

    Authors: Lou M. Almskog; Agneta Wikman; Jonas Svensson; Michael Wanecek; Matteo Bottai; Jan van der Linden; Anna Ågren

    doi:10.21203/rs.3.rs-57906/v1 Date: 2020-08-12 Source: ResearchSquare

    BackgroundHigh prevalence SERO of thrombotic MESHD events in severely ill COVID-19 patients have been reported. Pulmonary embolism HP Pulmonary embolism MESHD as well as microembolization of vital organs may in these individuals be direct causes of death MESHD. The identification of patients at high risk of developing thrombosis MESHD may lead to targeted, more effective prophylactic treatment. The aim of this study was to test whether Rotational Thromboelastometry MESHD ( ROTEM MESHD) indicates hypercoagulopathy in COVID-19 patients, and whether patients with severe disease have a more pronounced hypercoagulopathy compared with less severely ill patients. MethodsThe study was designed as a prospective observational study where COVID-19 patients over 18 years admitted to hospital were eligible for inclusion. Patients were divided into two groups depending on care level: 1) regular wards or 2) wards with specialized ventilation support. ROTEM MESHD was taken after admission and the data were compared with ROTEM MESHD in healthy controls.ResultsThe ROTEM MESHD variables Maximum Clot Firmness (EXTEM-/FIBTEM-MCF) were higher in COVID-19 patients compared with healthy controls (p<0.001) and higher in severely ill patients compared with patients at regular wards (p<0.05). Coagulation Time (EXTEM-CT) was longer and Clot Formation Time (EXTEM-CFT) shorter in COVID-19 patients compared with healthy controls. Our results suggest that hypercoagulopathy is present in hospitalized patients with mild to severe COVID-19 pneumonia HP pneumonia MESHD. ConclusionsROTEM variables were significantly different in COVID-19 patients early after admission compared with healthy controls. This pattern was more pronounced in patients with increased disease severity, suggesting that ROTEM MESHD-analysis may be useful to predict thromboembolic complications MESHD in these patients. 

    Pulmonary embolism HP Pulmonary embolism MESHD and screening for concomitant proximal deep vein thrombosis MESHD in noncritically ill hospitalized patients with coronavirus disease MESHD 2019.

    Authors: Álvaro Dubois-Silva; Cristina Barbagelata-López; Álvaro Mena; Patricia Piñeiro-Parga; Diego Llinares-García; Santiago Freire-Castro

    doi:10.21203/rs.3.rs-30389/v1 Date: 2020-05-19 Source: ResearchSquare

    Background The clinical characteristics of noncritically ill patients with coronavirus disease MESHD 2019 (COVID-19) who develop pulmonary embolism HP pulmonary embolism MESHD ( PE MESHD) and the prevalence SERO of concomitant proximal deep-vein thrombosis MESHD ( DVT MESHD) of the lower limbs have not been evaluated consistently.Methods We identified nonintensive care unit (non-ICU) patients admitted with COVID-19 who were diagnosed with PE MESHD at a single center in northwest Spain. Point-of-care compression ultrasonography (CUS) of the lower limbs was performed to screen for concomitant proximal DVT MESHD. Clinical data were analyzed retrospectively.Results From April 2 to April 17, 2020, 8 patients with COVID-19 and PE MESHD were identified. PE MESHD was diagnosed a median of 19 (interquartile range [IQR], 17–23) days after onset of COVID-19 symptoms and a median of 13 (IQR, 8–15) days after admission. All patients received thromboprophylaxis with enoxaparin or biosimilar at a median dose of 40 mg. All tested patients had high levels of D-dimer (≥2000 ng/mL), serum SERO ferritin (≥300 mg/dL) and IL-6 (≥5 pg/mL) at PE MESHD diagnosis. Six (75%) and 7 (87.5%) patients had high C-reactive-protein (≥1 mg/dL) and lactate dehydrogenase (≥250 U/L) levels, respectively. All PE MESHD events were segmental or subsegmental, with lobar involvement in only one. None of these patients had concomitant proximal DVT MESHD of the lower limbs on CUS.Conclusions Non-ICU hospitalized patients with COVID-19 diagnosed with PE MESHD had mainly segmental or subsegmental events without concomitant proximal DVT MESHD of the lower limbs. Our findings suggest a predominance of small-vessel thrombosis MESHD secondary to inflammatory and immune responses in these patients.

    Acute Pulmonary Embolism HP Pulmonary Embolism MESHD In Non-Hospitalized Covid-19 Patients Referred To CTPA By Emergency Department

    Authors: GERVAISE Alban; BOUZAD Caroline; PEROUX Evelyne; HELISSEY Carole

    doi:10.21203/rs.3.rs-26229/v1 Date: 2020-04-29 Source: ResearchSquare

    Objectives: To evaluate the prevalence SERO of acute pulmonary embolism HP pulmonary embolism MESHD (APE) in non-hospitalized COVID-19 patients referred to CT pulmonary angiography (CTPA) by Emergency Department.Methods: From March 14 to April 6, 2020, 72 non-hospitalized patients referred by Emergency Department to CTPA for COVID-19 pneumonia HP pneumonia MESHD were retrospectively identified. Relevant clinical and laboratory data and CT scan findings were collected for each patient. CTPA scans were reviewed by two radiologists to determinate the presence or absence of APE MESHD. Clinical classification, lung involvement of COVID-19 pneumonia HP pneumonia MESHD and CT total severity score were compared between APE group and Non-APE group.Results: APE was identified in 13 (18%) CTPA scans. The mean age TRANS and D-dimer of patients from APE group were higher in comparison with Non-APE group (74.4 vs. 59.6 years, p=0.008 and 7.29 vs. 3.29 µg/ml, p=0.011). There was no significant difference between APE and Non-APE groups concerning clinical type, COVID-19 pneumonia HP pneumonia MESHD lung lesions (ground-glass opacity: 85 vs. 97%; consolidation: 69 vs. 68%; crazy paving: 38% vs. 37%; linear reticulation: 69 vs. 78%), CT severity score (6.3 vs. 7.1, p=0.365), quality of CTPA (1.8 vs. 2.0, p=0.518) and pleural effusion HP pleural effusion MESHD (38% vs. 19%, p=0.146).Conclusions: Non-hospitalized patients with COVID-19 pneumonia HP pneumonia MESHD referred to CT-scan by Emergency Departments are at risk of APE. Presence of APE was not limited to severe or critical clinical type of COVID-19 pneumonia HP pneumonia MESHD.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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