Inflammation and Venous Thromboembolism in Hospitalized Patients with COVID-19.

C-reactive protein COVID-19 inflammatory indices interleukin-6 lymphocytopenia neutrophil-to-lymphocyte ratio triglyceride–glucose index venous thromboembolism

Journal

Diagnostics (Basel, Switzerland)
ISSN: 2075-4418
Titre abrégé: Diagnostics (Basel)
Pays: Switzerland
ID NLM: 101658402

Informations de publication

Date de publication:
19 Nov 2023
Historique:
received: 28 08 2023
revised: 04 11 2023
accepted: 17 11 2023
medline: 24 11 2023
pubmed: 24 11 2023
entrez: 24 11 2023
Statut: epublish

Résumé

A link between inflammation and venous thromboembolism (VTE) in COVID-19 disease has been suggested pathophysiologically and clinically. The aim of this study was to investigate the association between inflammation and disease outcomes in adult hospitalized COVID-19 patients with VTE. This was a retrospective observational study, including quantitative and qualitative data collected from COVID-19 patients hospitalized at the Infectious Diseases Unit (IDU) of the University Hospital of Ioannina, from 1 March 2020 to 31 May 2022. Venous thromboembolism was defined as a diagnosis of pulmonary embolism (PE) and/or vascular tree-in-bud in the lungs. The burden of disease, assessed by computed tomography of the lungs (CTBoD), was quantified as the percentage (%) of the affected lung parenchyma. The study outcomes were defined as death, intubation, and length of hospital stay (LoS). A chi-squared test and univariate logistic regression analyses were performed in IBM SPSS 28.0. After propensity score matching, the final study cohort included 532 patients. VTE was found in 11.2% of the total population. In patients with VTE, we found that lymphocytopenia and a high neutrophil/lymphocyte ratio were associated with an increased risk of intubation and death, respectively. Similarly, CTBoD > 50% was associated with a higher risk of intubation and death in this group of patients. The triglyceride-glucose (TyG) index was also linked to worse outcomes. Inflammatory indices were associated with VTE. Lymphocytopenia and an increased neutrophil-to-lymphocyte ratio negatively impacted the disease's prognosis and outcomes. Whether these indices unfavorably affect outcomes in COVID-19-associated VTE must be further evaluated.

Sections du résumé

BACKGROUND BACKGROUND
A link between inflammation and venous thromboembolism (VTE) in COVID-19 disease has been suggested pathophysiologically and clinically. The aim of this study was to investigate the association between inflammation and disease outcomes in adult hospitalized COVID-19 patients with VTE.
METHODS METHODS
This was a retrospective observational study, including quantitative and qualitative data collected from COVID-19 patients hospitalized at the Infectious Diseases Unit (IDU) of the University Hospital of Ioannina, from 1 March 2020 to 31 May 2022. Venous thromboembolism was defined as a diagnosis of pulmonary embolism (PE) and/or vascular tree-in-bud in the lungs. The burden of disease, assessed by computed tomography of the lungs (CTBoD), was quantified as the percentage (%) of the affected lung parenchyma. The study outcomes were defined as death, intubation, and length of hospital stay (LoS). A chi-squared test and univariate logistic regression analyses were performed in IBM SPSS 28.0.
RESULTS RESULTS
After propensity score matching, the final study cohort included 532 patients. VTE was found in 11.2% of the total population. In patients with VTE, we found that lymphocytopenia and a high neutrophil/lymphocyte ratio were associated with an increased risk of intubation and death, respectively. Similarly, CTBoD > 50% was associated with a higher risk of intubation and death in this group of patients. The triglyceride-glucose (TyG) index was also linked to worse outcomes.
CONCLUSIONS CONCLUSIONS
Inflammatory indices were associated with VTE. Lymphocytopenia and an increased neutrophil-to-lymphocyte ratio negatively impacted the disease's prognosis and outcomes. Whether these indices unfavorably affect outcomes in COVID-19-associated VTE must be further evaluated.

Identifiants

pubmed: 37998613
pii: diagnostics13223477
doi: 10.3390/diagnostics13223477
pmc: PMC10670045
pii:
doi:

Types de publication

Journal Article

Langues

eng

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Auteurs

Angelos Liontos (A)

1st Division of Internal Medicine & Infectious Diseases Unit, University General Hospital of Ioannina, Faculty of Medicine, University of Ioannina, 45500 Ioannina, Greece.

Dimitrios Biros (D)

1st Division of Internal Medicine & Infectious Diseases Unit, University General Hospital of Ioannina, Faculty of Medicine, University of Ioannina, 45500 Ioannina, Greece.

Rafail Matzaras (R)

1st Division of Internal Medicine & Infectious Diseases Unit, University General Hospital of Ioannina, Faculty of Medicine, University of Ioannina, 45500 Ioannina, Greece.

Konstantina-Helen Tsarapatsani (KH)

School of Electrical and Computer Engineering, National Technical University of Athens, 15773 Athens, Greece.

Nikolaos-Gavriel Kolios (NG)

Faculty of Medicine, University of Ioannina, 45110 Ioannina, Greece.

Athina Zarachi (A)

Department of Otorhinolaryngology, Head and Neck Surgery, University General Hospital of Ioannina, Faculty of Medicine, University of Ioannina, 451100 Ioannina, Greece.

Konstantinos Tatsis (K)

Department of Respiratory Medicine, University General Hospital of Ioannina, Faculty of Medicine, University of Ioannina, 451100 Ioannina, Greece.

Christiana Pappa (C)

Faculty of Medicine, University of Ioannina, 45110 Ioannina, Greece.

Maria Nasiou (M)

Faculty of Medicine, University of Ioannina, 45110 Ioannina, Greece.

Eleni Pargana (E)

Faculty of Medicine, University of Ioannina, 45110 Ioannina, Greece.

Ilias Tsiakas (I)

1st Division of Internal Medicine & Infectious Diseases Unit, University General Hospital of Ioannina, Faculty of Medicine, University of Ioannina, 45500 Ioannina, Greece.

Diamantina Lymperatou (D)

1st Division of Internal Medicine & Infectious Diseases Unit, University General Hospital of Ioannina, Faculty of Medicine, University of Ioannina, 45500 Ioannina, Greece.

Sempastien Filippas-Ntekouan (S)

1st Division of Internal Medicine & Infectious Diseases Unit, University General Hospital of Ioannina, Faculty of Medicine, University of Ioannina, 45500 Ioannina, Greece.

Lazaros Athanasiou (L)

1st Division of Internal Medicine & Infectious Diseases Unit, University General Hospital of Ioannina, Faculty of Medicine, University of Ioannina, 45500 Ioannina, Greece.

Valentini Samanidou (V)

1st Division of Internal Medicine & Infectious Diseases Unit, University General Hospital of Ioannina, Faculty of Medicine, University of Ioannina, 45500 Ioannina, Greece.

Revekka Konstantopoulou (R)

1st Division of Internal Medicine & Infectious Diseases Unit, University General Hospital of Ioannina, Faculty of Medicine, University of Ioannina, 45500 Ioannina, Greece.

Ioannis Vagias (I)

1st Division of Internal Medicine & Infectious Diseases Unit, University General Hospital of Ioannina, Faculty of Medicine, University of Ioannina, 45500 Ioannina, Greece.

Aikaterini Panteli (A)

1st Division of Internal Medicine & Infectious Diseases Unit, University General Hospital of Ioannina, Faculty of Medicine, University of Ioannina, 45500 Ioannina, Greece.

Haralampos Milionis (H)

1st Division of Internal Medicine & Infectious Diseases Unit, University General Hospital of Ioannina, Faculty of Medicine, University of Ioannina, 45500 Ioannina, Greece.

Eirini Christaki (E)

1st Division of Internal Medicine & Infectious Diseases Unit, University General Hospital of Ioannina, Faculty of Medicine, University of Ioannina, 45500 Ioannina, Greece.

Classifications MeSH