Estimation of Admission D-dimer Cut-off Value to Predict Venous Thrombotic Events in Hospitalized COVID-19 Patients: Analysis of the SEMI-COVID-19 Registry.

COVID-19 Fibrin Fibrinogen Degradation Products Hospitalization Humans Registries Retrospective Studies SARS-CoV-2 Venous Thromboembolism / diagnosis Venous Thrombosis / diagnosis
COVID-19 D-dimer SARS-CoV-2 deep vein thrombosis pulmonary embolism venous thrombotic event

Journal

Journal of general internal medicine
ISSN: 1525-1497
Titre abrégé: J Gen Intern Med
Pays: United States
ID NLM: 8605834

Informations de publication

Date de publication:
11 2021
Historique:
received: 01 02 2021
accepted: 29 06 2021
pubmed: 22 7 2021
medline: 26 11 2021
entrez: 21 7 2021
Statut: ppublish

Résumé

Venous thrombotic events (VTE) are frequent in COVID-19, and elevated plasma D-dimer (pDd) and dyspnea are common in both entities. To determine the admission pDd cut-off value associated with in-hospital VTE in patients with COVID-19. Multicenter, retrospective study analyzing the at-admission pDd cut-off value to predict VTE and anticoagulation intensity along hospitalization due to COVID-19. Among 9386 patients, 2.2% had VTE: 1.6% pulmonary embolism (PE), 0.4% deep vein thrombosis (DVT), and 0.2% both. Those with VTE had a higher prevalence of tachypnea (42.9% vs. 31.1%; p = 0.0005), basal O2 saturation <93% (45.4% vs. 33.1%; p = 0.0003), higher at admission pDd (median [IQR]: 1.4 [0.6-5.5] vs. 0.6 [0.4-1.2] μg/ml; p < 0.0001) and platelet count (median [IQR]: 208 [158-289] vs. 189 [148-245] platelets × 10 In hospitalized patients with COVID-19, a pDd value greater than 3.0 μg/ml can be considered to screen VTE and to consider full-dose anticoagulation.

Sections du résumé

BACKGROUND
Venous thrombotic events (VTE) are frequent in COVID-19, and elevated plasma D-dimer (pDd) and dyspnea are common in both entities.
OBJECTIVE
To determine the admission pDd cut-off value associated with in-hospital VTE in patients with COVID-19.
METHODS
Multicenter, retrospective study analyzing the at-admission pDd cut-off value to predict VTE and anticoagulation intensity along hospitalization due to COVID-19.
RESULTS
Among 9386 patients, 2.2% had VTE: 1.6% pulmonary embolism (PE), 0.4% deep vein thrombosis (DVT), and 0.2% both. Those with VTE had a higher prevalence of tachypnea (42.9% vs. 31.1%; p = 0.0005), basal O2 saturation <93% (45.4% vs. 33.1%; p = 0.0003), higher at admission pDd (median [IQR]: 1.4 [0.6-5.5] vs. 0.6 [0.4-1.2] μg/ml; p < 0.0001) and platelet count (median [IQR]: 208 [158-289] vs. 189 [148-245] platelets × 10
CONCLUSIONS
In hospitalized patients with COVID-19, a pDd value greater than 3.0 μg/ml can be considered to screen VTE and to consider full-dose anticoagulation.

Identifiants

DOI: 10.1007/s11606-021-07017-8 PMID: 34287774 PMC: PMC8294343
pubmed: 34287774
doi: 10.1007/s11606-021-07017-8
pii: 10.1007/s11606-021-07017-8
pmc: PMC8294343
doi:

Substances chimiques

Fibrin Fibrinogen Degradation Products 0
fibrin fragment D 0

Types de publication

Journal Article Multicenter Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

3478-3486

Commentaires et corrections

Type : CommentIn

Informations de copyright

© 2021. Society of General Internal Medicine.

Références

Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054-1062. https://doi.org/10.1016/S0140-6736(20)30566-3
doi: 10.1016/S0140-6736(20)30566-3 pubmed: 32171076 pmcid: 7270627
Onder G, Rezza G, Brusaferro S. Case-fatality rate and characteristics of patients dying in relation to COVID-19 in Italy. JAMA. 2020;323(18):1775–1776. https://doi.org/10.1001/jama.2020.4683
doi: 10.1001/jama.2020.4683 pubmed: 32203977
Wu C, Chen X, Cai Y, et al. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA Intern Med. 2020;180(7):934–943. https://doi.org/10.1001/jamainternmed.2020.0994
doi: 10.1001/jamainternmed.2020.0994 pubmed: 32167524
Llitjos, J-F, Leclerc, M, Chochois, C, et al. High incidence of venous thromboembolic events in anticoagulated severe COVID-19 patients. J Thromb Haemost. 2020; 18: 1743– 1746. https://doi.org/10.1111/jth.14869
doi: 10.1111/jth.14869 pubmed: 32320517
Middeldorp S, Coppens M, van Haaps TF, et al. Incidence of venous thromboembolism in hospitalized patients with COVID-19. J Thromb Haemost. 2020;18(8):1995-2002. https://doi.org/10.1111/jth.14888
doi: 10.1111/jth.14888 pubmed: 32369666 pmcid: 7497052
Klok FA, Kruip MJHA, van der Meer NJM, et al. Incidence of thrombotic complications in critically ill ICU patients with COVID-19. Thromb Res. 2020;191:145-147. https://doi.org/10.1016/j.thromres.2020.04.013
doi: 10.1016/j.thromres.2020.04.013 pubmed: 32291094 pmcid: 7146714
Grillet F, Behr J, Calame P, Aubry S, Delabrousse E. Acute pulmonary embolism associated with COVID-19 pneumonia detected with pulmonary CT angiography. Radiology. 2020;296(3):E186-E188. https://doi.org/10.1148/radiol.2020201544
doi: 10.1148/radiol.2020201544 pubmed: 32324103
Poissy J, Goutay J, Caplan M, et al. Pulmonary Embolism in Patients With COVID-19: Awareness of an Increased Prevalence. Circulation. 2020;142(2):184-186. https://doi.org/10.1161/CIRCULATIONAHA.120.047430
doi: 10.1161/CIRCULATIONAHA.120.047430 pubmed: 32330083
Franco-Moreno A, Herrera-Morueco M, Mestre-Gómez B, et al. Incidence of deep venous thrombosis in patients with COVID-19 and pulmonary embolism: Compression Ultrasound COVID Study [published online ahead of print, 2020 Oct 5]. J Ultrasound Med. 2020. https://doi.org/10.1002/jum.15524
Demelo-Rodríguez P, Cervilla-Muñoz E, Ordieres-Ortega L, et al. Incidence of asymptomatic deep vein thrombosis in patients with COVID-19 pneumonia and elevated D-dimer levels. Thromb Res. 2020;192:23-26. https://doi.org/10.1016/j.thromres.2020.05.018
doi: 10.1016/j.thromres.2020.05.018 pubmed: 32405101 pmcid: 7219400
Franco-Moreno A, Muñoz-Rivas N, Mestre-Gómez B, Torres-Macho J. Pulmonary embolism and COVID-19: a paradigm change. Tromboembolismo pulmonar y COVID-19: un cambio de paradigma. Rev Clin Esp. 2020;220(7):459-461. https://doi.org/10.1016/j.rce.2020.05.006
doi: 10.1016/j.rce.2020.05.006 pubmed: 33994570 pmcid: 7241371
Lodigiani C, Iapichino G, Carenzo L, et al. Venous and arterial thromboembolic complications in COVID-19 patients admitted to an academic hospital in Milan, Italy. Thromb Res. 2020;191:9-14. https://doi.org/10.1016/j.thromres.2020.04.024
doi: 10.1016/j.thromres.2020.04.024 pubmed: 32353746 pmcid: 7177070
Zhang L, Feng X, Zhang D, et al. Deep Vein Thrombosis in Hospitalized Patients With COVID-19 in Wuhan, China: Prevalence, Risk Factors, and Outcome. Circulation. 2020;142(2):114-128. https://doi.org/10.1161/CIRCULATIONAHA.120.046702
doi: 10.1161/CIRCULATIONAHA.120.046702 pubmed: 32421381
Trigonis RA, Holt DB, Yuan R, et al. Incidence of Venous Thromboembolism in Critically Ill Coronavirus Disease 2019 Patients Receiving Prophylactic Anticoagulation. Crit Care Med. 2020;48(9):e805-e808. https://doi.org/10.1097/CCM.0000000000004472
doi: 10.1097/CCM.0000000000004472 pubmed: 32618699
Helms J, Tacquard C, Severac F, et al. High risk of thrombosis in patients with severe SARS-CoV-2 infection: a multicenter prospective cohort study. Intensive Care Med. 2020;46(6):1089-1098. https://doi.org/10.1007/s00134-020-06062-x
doi: 10.1007/s00134-020-06062-x pubmed: 32367170
Léonard-Lorant I, Delabranche X, Séverac F, et al. Acute pulmonary embolism in patients with COVID-19 at CT angiography and relationship to D-dimer levels. Radiology. 2020;296(3):E189-E191. https://doi.org/10.1148/radiol.2020201561
doi: 10.1148/radiol.2020201561 pubmed: 32324102
Cui S, Chen S, Li X, Liu S, Wang F. Prevalence of venous thromboembolism in patients with severe novel coronavirus pneumonia. J Thromb Haemost. 2020;18(6):1421-1424. https://doi.org/10.1111/jth.14830
doi: 10.1111/jth.14830 pubmed: 32271988
Nicholson M, Chan N, Bhagirath V, Ginsberg J. Prevention of venous thromboembolism in 2020 and beyond. J Clin Med. 2020;9(8):2467. https://doi.org/10.3390/jcm9082467
doi: 10.3390/jcm9082467 pmcid: 7465935
Malato A, Dentali F, Siragusa S, et al. The impact of deep vein thrombosis in critically ill patients: a meta-analysis of major clinical outcomes. Blood Transfus. 2015;13(4):559-568. https://doi.org/10.2450/2015.0277-14
doi: 10.2450/2015.0277-14 pubmed: 26513770 pmcid: 4624530
Ciuti G, Grifoni E, Pavellini A, et al. Incidence and characteristics of asymptomatic distal deep vein thrombosis unexpectedly found at admission in an internal medicine setting. Thromb Res. 2012;130(4):591-595. https://doi.org/10.1016/j.thromres.2012.05.018
doi: 10.1016/j.thromres.2012.05.018 pubmed: 22694877
Konstantinides SV, Meyer G, Becattini C, et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J. 2020;41(4):543-603. https://doi.org/10.1093/eurheartj/ehz405
doi: 10.1093/eurheartj/ehz405 pubmed: 31504429
Righini M, Van Es J, Den Exter PL, et al. Age-adjusted D-dimer cutoff levels to rule out pulmonary embolism: The ADJUST-PE Study. JAMA 2014;311(11):1117–1124. https://doi.org/10.1001/jama.2014.2135
doi: 10.1001/jama.2014.2135 pubmed: 24643601
Casas-Rojo JM, Antón-Santos JM, Millán-Núñez-Cortés J, et al. Clinical characteristics of patients hospitalized with COVID-19 in Spain: results from the SEMI-COVID-19 Registry. Características clínicas de los pacientes hospitalizados con COVID-19 en España: resultados del Registro SEMI-COVID-19. Rev Clin Esp. 2020;220(8):480-494. https://doi.org/10.1016/j.rce.2020.07.003
doi: 10.1016/j.rce.2020.07.003 pubmed: 33994573 pmcid: 7368900
World Health Organization. Laboratory testing for coronavirus disease 2019 (COVID-19) in suspected human cases. 2020;(March):1-7. https://www.who.int/publications/i/item/laboratory-testing-for-2019-novel-coronavirus-in-suspected-human-cases-20200117 . Accessed 29 Jun 2020
von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008;61(4):344-349. https://doi.org/10.1016/j.jclinepi.2007.11.008
doi: 10.1016/j.jclinepi.2007.11.008
Charlson M, Szatrowski TP, Peterson J, Gold J. Validation of a combined comorbidity index. J Clin Epidemiol. 1994;47(11):1245-1251. https://doi.org/10.1016/0895-4356(94)90129-5
doi: 10.1016/0895-4356(94)90129-5 pubmed: 7722560
Henry BM, Vikse J, Benoit S, Favaloro EJ, Lippi G. Hyperinflammation and derangement of renin-angiotensin-aldosterone system in COVID-19: a novel hypothesis for clinically suspected hypercoagulopathy and microvascular immunothrombosis. Clin Chim Acta. 2020;507:167-173. https://doi.org/10.1016/j.cca.2020.04.027 .
doi: 10.1016/j.cca.2020.04.027 pubmed: 32348783 pmcid: 7195008
Sardu C, Gambardella J, Morelli MB, Wang X, Marfella R, Santulli G. Hypertension, thrombosis, kidney failure, and diabetes: is COVID-19 an endothelial disease? A Comprehensive Evaluation of Clinical and Basic Evidence. J Clin Med. 2020;9(5):1417. https://doi.org/10.3390/jcm9051417
doi: 10.3390/jcm9051417 pmcid: 7290769
Connors JM, Levy JH. COVID-19 and its implications for thrombosis and anticoagulation. Blood. 2020;135(23):2033-2040. https://doi.org/10.1182/blood.2020006000
doi: 10.1182/blood.2020006000 pubmed: 32339221
Lax SF, Skok K, Zechner P, et al. Pulmonary Arterial Thrombosis in COVID-19 With Fatal Outcome : Results From a Prospective, Single-Center, Clinicopathologic Case Series, Ann Intern Med. 2020;173(5):350-361. https://doi.org/10.7326/M20-2566
doi: 10.7326/M20-2566 pubmed: 32422076
Dolhnikoff M, Duarte-Neto AN, de Almeida Monteiro RA, et al. Pathological evidence of pulmonary thrombotic phenomena in severe COVID-19. J Thromb Haemost. 2020;18(6):1517-1519. https://doi.org/10.1111/jth.14844
doi: 10.1111/jth.14844 pubmed: 32294295
Varga Z, Flammer AJ, Steiger P, et al. Endothelial cell infection and endotheliitis in COVID-19. Lancet. 2020;395(10234):1417-1418. https://doi.org/10.1016/S0140-6736(20)30937-5
doi: 10.1016/S0140-6736(20)30937-5 pubmed: 32325026 pmcid: 7172722
Magro C, Mulvey JJ, Berlin D, et al. Complement associated microvascular injury and thrombosis in the pathogenesis of severe COVID-19 infection: a report of five cases. Transl Res. 2020;220:1-13. https://doi.org/10.1016/j.trsl.2020.04.007
doi: 10.1016/j.trsl.2020.04.007 pubmed: 32299776 pmcid: 7158248
Wang X, Sahu KK, Cerny J. Coagulopathy, endothelial dysfunction, thrombotic microangiopathy and complement activation: potential role of complement system inhibition in COVID-19 [published online ahead of print, 2020 Oct 15]. J Thromb Thrombolysis. 2020;1-6. https://doi.org/10.1007/s11239-020-02297-z
Tang N, Bai H, Chen X, Gong J, Li D, Sun Z. Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy. J Thromb Haemost. 2020;18(5):1094-1099. https://doi.org/10.1111/jth.14817
doi: 10.1111/jth.14817 pubmed: 32220112
Flaczyk A, Rosovsky RP, Reed CT, Bankhead-Kendall BK, Bittner EA, Chang MG. Comparison of published guidelines for management of coagulopathy and thrombosis in critically ill patients with COVID 19: implications for clinical practice and future investigations. Crit Care. 2020;24(1):1-13. https://doi.org/10.1186/s13054-020-03273-y
doi: 10.1186/s13054-020-03273-y
Thachil J, Tang N, Gando S, et al. ISTH interim guidance on recognition and management of coagulopathy in COVID-19. J Thromb Haemost. 2020;18(5):1023-1026. https://doi.org/10.1111/jth.14810
doi: 10.1111/jth.14810 pubmed: 32338827
Bikdeli B, Madhavan MV, Jimenez D, et al. COVID-19 and thrombotic or thromboembolic disease: implications for prevention, antithrombotic therapy, and follow-up: JACC State-of-the-Art Review. J Am Coll Cardiol. 2020;75(23):2950-2973. https://doi.org/10.1016/j.jacc.2020.04.031
doi: 10.1016/j.jacc.2020.04.031 pubmed: 32311448 pmcid: 7164881
Piagnerelli M, Cauchie P, Wautrecht JC. Optimizing the risk-benefit balance of thromboprophylaxis in critically ill patients with coronavirus disease 2019. Crit Care Med. 2020;48(10):e988-e989. https://doi.org/10.1097/CCM.0000000000004509
doi: 10.1097/CCM.0000000000004509 pubmed: 32706558
Maatman TK, Jalali F, Feizpour C, et al. Routine venous thromboembolism prophylaxis may be inadequate in the hypercoagulable state of severe coronavirus disease 2019. Crit Care Med. 2020;48(9):e783-e790. https://doi.org/10.1097/CCM.0000000000004466
doi: 10.1097/CCM.0000000000004466 pubmed: 32459672

Auteurs

Carles García-Cervera (C)

General Internal Medicine Department, Hospital Universitario San Juan de Alicante, San Juan de Alicante, Alicante, Spain.
ORCID: 0000-0001-8019-1641

Vicente Giner-Galvañ (V)

General Internal Medicine Department, Hospital Universitario San Juan de Alicante, San Juan de Alicante, Alicante, Spain.
Department of Clinical Medicine, Faculty of Medicine, Miguel Hernández University, Elche, Alicante, Spain.
Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Conselleria de Sanitat, Generalitat Valenciana, Valencia, Spain.

Philip Wikman-Jorgensen (P)

General Internal Medicine Department, Hospital Universitario San Juan de Alicante, San Juan de Alicante, Alicante, Spain. wikman.philip@gmail.com.
Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Conselleria de Sanitat, Generalitat Valenciana, Valencia, Spain. wikman.philip@gmail.com.

Jaime Laureiro (J)

Internal Medicine Department, 12 de Octubre University Hospital, Madrid, Spain.

Manuel Rubio-Rivas (M)

Internal Medicine Department, Bellvitge University Hospital-IDIBELL, Barcelona, Spain.

Anthony Gurjian Arena (A)

Internal Medicine Department, Gregorio Marañon University Hospital, Madrid, Spain.

Francisco Arnalich-Fernandez (F)

Internal Medicine Department, La Paz University Hospital, Madrid, Spain.

José Luis Beato Pérez (JL)

Internal Medicine Department, Albacete University Hospital Complex, Albacete, Spain.

Juan Antonio Vargas Núñez (JA)

Internal Medicine Department, Puerta de Hierro University Hospital, Majadahonda, Madrid, Spain.

Jesús Javier González Igual (JJ)

Internal Medicine Department, Miguel Servet Hospital, Zaragoza, Spain.

Jesús Díez-Manglano (J)

Internal Medicine Department, Royo Villanova Hospital, Zaragoza, Spain.

Manuel Méndez Bailón (M)

Internal Medicine Department, San Carlos Clinical Hospital, Madrid, Spain.

María José García Blanco (MJ)

Internal Medicine Department, La Princesa University Hospital, Madrid, Spain.

Santiago J Freire Castro (SJ)

Internal Medicine Department, A Coruña University Hospital, A Coruña, Spain.

Judit Aranda Lobo (J)

Internal Medicine Department, Consorci Sanitari Integral - Moisès Broggi Hospital, Sant Joan Despí, Barcelona, Spain.

Luis Manzano (L)

Internal Medicine Department, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain.

Jeffrey Oskar Magallanes Gamboa (JO)

Internal Medicine Department, Nuestra Señora del Prado Hospital, Talavera de la Reina, Toledo, Spain.

Luis Arribas Pérez (L)

Internal Medicine Department, Zamora Hospital Complex, Zamora, Spain.

Julio González Moraleja (J)

Internal Medicine Department, Virgen de la Salud Hospital, Toledo, Spain.

Ruth Calderón Hernaiz (R)

Internal Medicine Department, Infanta Cristina University Hospital, Parla, Madrid, Spain.

Javier García Alegría (J)

Internal Medicine Department, Costa del Sol Hospital, Marbella, Málaga, Spain.

Amara González Noya (A)

Internal Medicine Department, Ourense University Hospital Complex, Ourense, Spain.

Ricardo Gómez Huelgas (R)

Internal Medicine Department, Regional University Hospital of Málaga, Biomedical Research Institute of Málaga (IBIMA), University of Málaga (UMA), Málaga, Spain.

Carlos Lumbreras Bermejo (C)

Internal Medicine Department, 12 de Octubre University Hospital, Madrid, Spain.

Juan Miguel Antón Santos (JM)

Internal Medicine Department, Infanta Cristina University Hospital, Parla, Madrid, Spain.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female

Evaluation of Low-Value Services Across Major Medicare Advantage Insurers and Traditional Medicare.

Ciara Duggan, Adam L Beckman, Ishani Ganguli et al.
1.00
Humans United States Aged Cross-Sectional Studies Medicare Part C

Effectiveness of Virtual Yoga for Chronic Low Back Pain: A Randomized Clinical Trial.

Hallie Tankha, Devyn Gaskins, Amanda Shallcross et al.
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH

questionsmedicales.fr › Maladies de l'appareil respiratoire › Infections de l'appareil respiratoire › Pneumopathie infectieuse › Pneumopathie virale › COVID-19 › Estimation of Admission D-dimer Cut-off Value...
questionsmedicales.fr › Acides aminés, peptides et protéines › Protéines › Précurseurs de protéines › Produits de dégradation de la fibrine et du fibrinogène › Estimation of Admission D-dimer Cut-off Value...
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Services de santé › Soins aux patients › Hospitalisation › Estimation of Admission D-dimer Cut-off Value...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Estimation of Admission D-dimer Cut-off Value...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Collecte de données › Enregistrements › Estimation of Admission D-dimer Cut-off Value...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Estimation of Admission D-dimer Cut-off Value...
questionsmedicales.fr › Virus › Virus à ARN › Virus à ARN à brin positif › Nidovirales › Coronaviridae › Coronavirus › Betacoronavirus › Virus du SRAS › SARS-CoV-2 › Estimation of Admission D-dimer Cut-off Value...
questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Embolie et thrombose › Thromboembolie › Thromboembolisme veineux › Estimation of Admission D-dimer Cut-off Value...
questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Embolie et thrombose › Thrombose › Thrombose veineuse › Estimation of Admission D-dimer Cut-off Value...