White blood count, D-dimers, and ferritin levels as predictive factors of pulmonary embolism suspected upon admission in noncritically ill COVID-19 patients: The French multicenter CLOTVID retrospective study.


Journal

European journal of haematology
ISSN: 1600-0609
Titre abrégé: Eur J Haematol
Pays: England
ID NLM: 8703985

Informations de publication

Date de publication:
Aug 2021
Historique:
revised: 23 04 2021
received: 03 04 2021
accepted: 26 04 2021
entrez: 21 7 2021
pubmed: 22 7 2021
medline: 31 7 2021
Statut: ppublish

Résumé

A high prevalence of pulmonary embolism (PE) has been described during COVID-19. Our aim was to identify predictive factors of PE in non-ICU hospitalized COVID-19 patients. Data and outcomes were collected upon admission during a French multicenter retrospective study, including patients hospitalized for COVID-19, with a CT pulmonary angiography (CTPA) performed in the emergency department for suspected PE. Predictive factors significantly associated with PE were identified through a multivariate regression model. A total of 88 patients (median [IQR] age of 68 years [60-78]) were analyzed. Based on CTPA, 47 (53.4%) patients were diagnosed with PE, and 41 were not. D-dimer ≥3000 ng/mL (OR 8.2 [95% CI] 1.3-74.2, sensitivity (Se) 0.84, specificity (Sp) 0.78, P = .03), white blood count (WBC) ≥12.0 G/L (29.5 [2.3-1221.2], Se 0.47, Sp 0.92, P = .02), and ferritin ≥480 µg/L (17.0 [1.7-553.3], Se 0.96, Sp 0.44, P = .03) were independently associated with the PE diagnosis. The presence of the double criterion D-dimer ≥3000 ng/mL and WBC ≥12.0 G/L was greatly associated with PE (OR 21.4 [4.0-397.9], P = .004). The white blood count, the D-dimer and ferritin levels could be used as an indication for CTPA to confirm PE on admission in non-ICU COVID-19 patients.

Sections du résumé

BACKGROUND BACKGROUND
A high prevalence of pulmonary embolism (PE) has been described during COVID-19. Our aim was to identify predictive factors of PE in non-ICU hospitalized COVID-19 patients.
METHODS METHODS
Data and outcomes were collected upon admission during a French multicenter retrospective study, including patients hospitalized for COVID-19, with a CT pulmonary angiography (CTPA) performed in the emergency department for suspected PE. Predictive factors significantly associated with PE were identified through a multivariate regression model.
RESULTS RESULTS
A total of 88 patients (median [IQR] age of 68 years [60-78]) were analyzed. Based on CTPA, 47 (53.4%) patients were diagnosed with PE, and 41 were not. D-dimer ≥3000 ng/mL (OR 8.2 [95% CI] 1.3-74.2, sensitivity (Se) 0.84, specificity (Sp) 0.78, P = .03), white blood count (WBC) ≥12.0 G/L (29.5 [2.3-1221.2], Se 0.47, Sp 0.92, P = .02), and ferritin ≥480 µg/L (17.0 [1.7-553.3], Se 0.96, Sp 0.44, P = .03) were independently associated with the PE diagnosis. The presence of the double criterion D-dimer ≥3000 ng/mL and WBC ≥12.0 G/L was greatly associated with PE (OR 21.4 [4.0-397.9], P = .004).
CONCLUSION CONCLUSIONS
The white blood count, the D-dimer and ferritin levels could be used as an indication for CTPA to confirm PE on admission in non-ICU COVID-19 patients.

Identifiants

pubmed: 34288162
doi: 10.1111/ejh.13638
pmc: PMC8239942
doi:

Substances chimiques

Fibrin Fibrinogen Degradation Products 0
fibrin fragment D 0
Ferritins 9007-73-2

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

190-201

Investigateurs

Albertini Mathieu (A)
Bouajila Sara (B)
Britany Kimbimbi (B)
Burlacu Ruxandra (B)
Cacoub Léa (C)
Champion Karine (C)
Delcey Véronique (D)
Dillinger Jean-Guillaume (D)
Feron Florine (F)
Frazier Aline (F)
Thomas Funck-Bretano (T)
Gauthier Diane-Cecile (G)
Gautier Jean-François (G)
Henry Patrick (H)
Huscenot Tessa (H)
Sarah Izabel (S)
Mathilde Jaulerry (M)
Jouabli Moenes (J)
Julla Jean-Baptiste (J)
Laloi Michelin Marie (LM)
Leroy Pierre (L)
Lopes Amanda (L)
Megarbane Bruno (M)
Michon Maxime (M)
Munier Anne-Lise (M)
Nahmani Yoram (N)
Nicol Martin (N)
Nicolas Eroan (N)
Poulat Audrey (P)
Revue Eric (R)
Richette Pascal (R)
Riveline Jean-Pierre (R)
Rubenstein Emma (R)
Zanin Adrien (Z)
Aveneau Clément (A)
Bastard Paul (B)
Beauvais Diane (B)
Boghez Loredana (B)
Borderiou Alix (B)
Conway Paul (C)
Cosma Lavignia (C)
Davy Vincent (D)
Desjardin Clément (D)
Devatine Sandra (D)
Ducroz Gerardin Christel (DG)
Dupe Charlotte (D)
Gobert Chloé (G)
Gros Clotilde (G)
Kadiri Soumaya (K)
Khan Enmat (K)
Ongnessek Sandrine (O)
Rhmari Fatima (R)
Sacco Isabelle (S)
Saptefrat Natalia (S)
Schaupp Pauline (S)
Serre Justine (S)
Sideris Georgios (S)
Smati Sonia (S)
Tournier Marine (T)
Treca Pauline (T)
Truong Tony (T)
Tuffier Mathilde (T)
Arcelli Mattéo (A)
Boue Yvonnick (B)
Copie Alban (C)
Deye Nicolas (D)
Ekherian Jean-Michel (E)
Errabih Zaccaria (E)
Gonde Antoine (G)
Grant Caroline (G)
Guerin Emmanuelle (G)
Magalhaes Adèle (M)
Malissin Isabelle (M)
Meurisse Edouard (M)
Mrad Aymen (M)
Naim Giulia (N)
Nguyen Philippe (N)
Nitenberg Kiyoko (N)
Pepin-Lehalleur Adrien (PL)
Perault Arthur (P)
Perrin Lucile (P)
Renaud Maxime (R)
Sutterlin Laetitia (S)
Delrue Maxime (D)
Siguret Virginie (S)
Stepanian Alain (S)

Informations de copyright

© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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Auteurs

Joris Galland (J)

Department of Internal Medicine, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.
University of Paris, Paris, France.

Benjamin Thoreau (B)

University of Paris, Paris, France.
Department of Internal Medicine, National Referral Center for Rare Systemic Autoimmune Diseases, Cochin Hospital, AP-HP, Université de Paris, Paris, France.
INSERM U1016, CNRS UMR 8104, Cochin Institute, Paris, France.

Maxime Delrue (M)

Hematology Laboratory, Lariboisière Hospital, AP-HP, University of Paris, Paris, France.
EA 3518, Paris University, Paris, France.

Marie Neuwirth (M)

Hematology Laboratory, Lariboisière Hospital, AP-HP, University of Paris, Paris, France.
INSERM UMRS U1140, Paris University, Paris, France.

Alain Stepanian (A)

Hematology Laboratory, Lariboisière Hospital, AP-HP, University of Paris, Paris, France.
EA 3518, Paris University, Paris, France.

Anthony Chauvin (A)

University of Paris, Paris, France.
Emergency Department, Lariboisière Hospital, AP-HP, University of Paris, Paris, France.

Azeddine Dellal (A)

Department of Rheumatology and Internal Medicine, Le Raincy-Montfermeil Hospital, Montfermeil, France.

Olivier Nallet (O)

Department of Cardiology, Le Raincy-Montfermeil Hospital, Montfermeil, France.

Melanie Roriz (M)

Department of Internal Medicine, Hospital Center of Agen, Agen, France.

Mathilde Devaux (M)

Department of Internal Medicine, Hospital Center of Poissy-Saint Germain, Saint Germain en Laye, France.

Jonathan London (J)

Department of Internal Medicine, Diaconesses Croix Saint-Simon Hospital, Paris, France.

Gonzague Martin-Lecamp (G)

Department of Internal Medicine, Hospital Center of Pau, Pau, France.

Antoine Froissart (A)

Department of Internal Medicine, Intermunicipal Hospital Center of Créteil, Créteil, France.

Nouara Arab (N)

Department of Internal Medicine, Intermunicipal Hospital Center of Créteil, Créteil, France.

Bertrand Ferron (B)

Department of Internal Medicine, Hospital Center of Sens, Sens, France.

Marie-Helene Groff (MH)

Department of Internal Medicine, Hospital Center of Nord-Mayenne, Mayenne, France.

Viviane Queyrel (V)

Department of Internal Medicine, University Hospital of Nice, Nice, France.

Christine Lorut (C)

Department of Pneumology, Cochin Hospital, AP-HP, Université de Paris, Paris, France.

Lucile Regard (L)

Department of Pneumology, Cochin Hospital, AP-HP, Université de Paris, Paris, France.

Emilie Berthoux (E)

Department of Internal Medicine, Saint Luc-Saint Joseph Hospital, Lyon, France.

Guillaume Bayer (G)

Department of Internal Medicine, Claude Galien Hospital, Quincy sous Senart, France.

Chloe Comarmond (C)

Department of Internal Medicine, Pitié-Salpétrière Hospital, AP-HP, Sorbonne University, Paris, France.
Sorbonne University, Paris, France.

Bertrand Lioger (B)

Department of Internal Medicine, Simone Veil Hospital, Blois, France.

Arsène Mekinian (A)

Sorbonne University, Paris, France.
Department of Internal Medicine, Saint Antoine Hospital, APHP, Paris, France.

Tali-Anne Szwebel (TA)

Department of Internal Medicine, National Referral Center for Rare Systemic Autoimmune Diseases, Cochin Hospital, AP-HP, Université de Paris, Paris, France.

Thomas Sené (T)

Department of Internal Medicine, Fondation Rothschild, Paris, France.

Blanca Amador-Boreiro (B)

Department of Internal Medicine, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.
University of Paris, Paris, France.

Olivier Mangin (O)

Department of Internal Medicine, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.
University of Paris, Paris, France.

Pierre-Olivier Sellier (PO)

Department of Infectious Diseases, Lariboisière Hospital, APHP, Paris, France.

Stephane Mouly (S)

Department of Internal Medicine, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.
University of Paris, Paris, France.

Jean-Philippe Kevorkian (JP)

Department of Endocrinology, Lariboisière Hospital, APHP, Paris, France.

Virginie Siguret (V)

University of Paris, Paris, France.
Hematology Laboratory, Lariboisière Hospital, AP-HP, University of Paris, Paris, France.
INSERM UMRS U1140, Paris University, Paris, France.

Dominique Vodovar (D)

University of Paris, Paris, France.
Centre Anti-Poison, Fernand Widal Hospital, AP-HP, University of Paris, Paris, France.
INSERM UMRS 1144, Paris, France.

Damien Sene (D)

Department of Internal Medicine, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.
University of Paris, Paris, France.

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